Special Report: “Caught in the Healthcare Crossfire”

JACKSON, Mississippi (WJTV) – While the future of healthcare is being decided in Washington, D.C., some Mississippi families are dealing with problems under the current Medicaid system.

More than 400,000 children in Mississippi rely on Medicaid and some of those children have been going to a children’s hospital in Birmingham for reasons that range from convenience to the level of care they receive.  Children’s Hospital of Alabama stopped accepting Mississippi Medicaid earlier this year.

WJTV’s Beth Alexander took a closer look at those caught in the healthcare crossfire.

Haddon Alexander was diagnosed with cystic fibrosis when he was three.  He and his family live in Tupelo, so it was closer for them to go to a hospital in Memphis, Tennessee than to travel four hours to Batson Children’s Hospital in Jackson.  But treatment in Memphis was not up to his parents’ standards, so they took him to Children’s Hospital of Alabama in Birmingham.   Clay Anthony says, “Part and parcel just out of the ballpark better than anything we’ve experience.”  Says parent Lanell Anthony, “When we switched to UAB he gained seven pounds in one month, and it was just through some new ideas and new things they instituted for Haddon.”

In March, however, Children’s of Alabama stopped accepting Haddon’s Medicaid coverage.  The hospital issued a statement to WJTV.  It reads, in part: “We are saddened that, after more than 18 months of trying, we have not been able to successfully negotiate provider agreements with acceptable terms with the managed care contractors.  Children’s is committed to helping the affected patient families through this transition to services available in Mississippi provided by in-state and in-network providers.”

The Mississippi Division of Medicaid says, “Children’s Hospital of Alabama made the decision to stop accepting Mississippi Medicaid.  While they currently do not accept Mississippi Medicaid, they are still an enrolled provider and their provider agreement is still in place.”  The statement continues to indicate that they are hopeful to find a solution.

Congressman Gregg Harper says, “I really don’t think this is in the best interest of those children to do this…There are some places that you can only get services there to that degree and with what’s happened they need to continue on that and the families we’ve talked with.  We’re trying to make sure the parties are trying to talk to watch other…and really we hope that this isn’t the end of this story for the sake of these children.”  Rep. Harper says he has talked to families affected by the change.  He is hopeful that Children’s of Alabama will reconsider.  “If it’s something they need the State of Mississippi to do then outline it, tell us exactly what you need but at this point we do believe the children’s hospital in Alabama has a moral responsibility to keep treating those children at the same rate that they’ve been doing it.”

“…We do believe the children’s hospital in Alabama has a moral responsibility to keep treating those children at the same rate that they’ve been doing it.” Congressman Gregg Harper

 

Haddon is now a teenager and an avid runner.  His mom, Lanell, says at this age it is important not to move him from hospital to hospital.  They also do not want to give up the convenience of going to Birmingham. She says, “When we travel to Alabama it’s two hours and ten minutes from our home.  We can drive there in a day and come back.  If we have to choose Batson’s it’s going to be an overnight trip, which means hotel, extra expense, food, and another whole day of school that we will have to miss.”

Graphic Credit: Google Maps  (www.google.com/maps/)

 

Graphic Credit: Google Maps (www.google.com/maps/)

 

Haddon is not the only child impacted.  Children’s of Alabama says that over the last two years 143 patients have used Mississippi Medicaid as their primary insurance.  The State Division of Medicaid says that over the past two years 300 Mississippi children have used the insurance in Alabama.

WJTV’s Alexander contacted Batson Children’s Hospital to get their take on this.  They say there is not change in Medicaid coverage at Batson.  Guy Giesecke is CEO of Children’s of Mississippi. In a statement he says, “We have the physicians and services to accommodate those who are affected.  Patients’ families can feel free to reach out to us, and we will be happy to coordinate with physicians in Alabama to make sure children get the care they need.”  Children’s is the designated research clinic for a new therapy drug so the Anthony’s say they will continue taking Haddon to Alabama for treatment.  They will use private insurance to cover it.  Lanell Anthony says, “Parents like us will be in financial debt that is just what we choose for the best care for our child.

Medicaid has two coordinated care companies – Magnolia Health and UnitedHealthcare Community Plan.  The Mississippi Division of Medicaid says they are not aware of any non-payment or late payment by those providers.

Magnolia did not respond to our request for a comment for this story.  But United did.  A statement from United reads as follows: “Children’s Hospital of Alabama has never participated in UnitedHealthcare’s Medicaid network and it was the hospital’s decision to now stop seeing Mississippi Medicaid patients.  Children’s Hospital was paid consistent with any out-of-network provider who elects not to participate in a health plan’s network.”

 

 

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