Nevada Medicaid is seeking proposals from insurers to offer a Coordination Only Dual Eligible Special Needs Plan. Proposals are due Feb. 17, with a contract expected to run from Jan. 1, 2027 through Dec. 31, 2030. The state may award…
Payer Contracting
More than 850,000 members of Horizon NJ Health, the managed Medicaid plan operated by Horizon Blue Cross Blue Shield of New Jersey, will lose in-network access to CVS pharmacies after April 30. The insurer is advising affected members to transfer…
Anthem Blue Cross and Montage Health’s Community Hospital of the Monterey Peninsula (Calif.) have established an agreement Jan. 26, just ahead of their end-of-month contract deadline, both organizations confirmed in a news release shared with Becker’s. The agreement keeps members…
Allentown, Pa.-based Lehigh Valley Health Network, part of Jefferson Health, will exit UnitedHealthcare’s Medicare Advantage network Jan. 26, following a contract dispute between the two organizations. Five things to know: 1. After months of negotiations, LVHN said UnitedHealthcare has not…
UnitedHealthcare and St. Louis-based SSM Health have reached a multi-year agreement Jan. 20, amid a contract extension through Jan. 31, according to a news release shared with Becker’s. The agreement ensures individuals with commercial and Medicaid plans can still receive…
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Four hospitals under Grand Rapids and Southfield, Mich.-based Corewell Health are no longer in UnitedHealthcare’s network, according to a Dec. 31 update from the insurer. As of Jan. 1, UnitedHealthcare does not cover the Dearborn, Taylor, Trenton and Wayne hospitals…
Cigna and Chattanooga, Tenn.-based Memorial Hospital — under Chicago-based CommonSpirit Health, formerly CHI Memorial — have not reached an agreement ahead of their Feb. 1 contracting deadline. “We have a longstanding relationship with Memorial Hospital and want them to remain…
New York City-based Mount Sinai physicians are no longer in Anthem’s network as of Jan. 1, according to both organizations. The contract expired Dec. 31, 2025, following negotiations which began in the spring. All Mount Sinai facilities will go out…
As the end of 2025 approaches, so do a handful of payer-provider agreements. Earlier this year, the number of contract disputes were down. While some insurers and health systems reach a resolution — either before or even after their deadlines…
Cigna and Dallas-based Tenet Healthcare reached an agreement in their contract dispute, a Cigna spokesperson confirmed Dec. 31 to Becker’s. Tenet has 64 hospitals, nearly 370 ambulatory surgical centers and roughly 2,000 providers across the country. “An agreement has been…