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Nashville mayor urges expedited negotiations in Vanderbilt Health-Humana dispute
Nashville, Tenn., Mayor John Cooper sent letters to Vanderbilt University Medical Center and Humana officials urging the sides to prevent "what could otherwise unfold into catastrophic scenarios" if the health system splits with the insurer's Medicare Advantage plan. -
Blue Cross NC appeals state's decision to award Aetna state health plan contract
Blue Cross and Blue Shield of North Carolina is appealing North Carolina's decision to award its state employee health plan contract to Aetna. -
Vanderbilt Health dropping Humana, Wellcare Medicare Advantage plans
Vanderbilt University Medical Center announced it will drop Humana and Wellcare of Tennessee Medicare Advantage plans effective April 1, NBC affiliate WSMV reported Jan. 10. -
9 ongoing payer-provider contract disputes and recent splits
Some payers and health systems have split in recent weeks, unable to meet year-end contract deadlines. Others are facing looming deadlines to reach agreements without disrupting patient care. Here are nine ongoing contract disputes and failed negotiations, as of Jan. 10. -
Regence BlueShield of Washington Medicare Advantage members still waiting for resolution with Optum-owned clinics
Despite coming to an agreement to keep Regence BlueShield of Washington commercial members in-network at the Polyclinic and Everett Clinic, the payer's Medicare advantage members are still left in limbo, The Daily Herald reported Jan. 10. -
Anthem Blue Cross, Mary Washington Healthcare could split March 1
Anthem Blue Cross could go out of network with Fredericksburg, Va.-based Mary Washington Healthcare if the two sides can't agree on a new contract by March 1, The Free Lance-Star reported Jan. 7. -
Centene, Missouri health system split, affecting foster care children and families
Centene and Springfield, Mo.-based CoxHealth will go out of network Feb. 16 after the two sides were unable to reach a new contract agreement, Springfield News-Leader reported Jan. 9. -
Why North Carolina unanimously chose Aetna over BCBS
Cost savings and more price transparency were cited as reasons why North Carolina ended a 40-year relationship with Blue Cross Blue Shield and chose Aetna to administer employee health benefits. -
BCBS Texas, Ascension Texas could split, affecting 66,000 patients
Blue Cross Blue Shield of Texas and Ascension hospitals in Texas are facing a looming Feb. 1 deadline to avoid a split that could impact 66,000 patients, the Austin-American Statesman reported Jan. 6. -
Cigna, Mercy Health reach agreement in dispute affecting 12,000 patients
Cigna of Ohio and Cincinnati-based Mercy Health reached an agreement to keep over 12,000 patients in-network, the Cincinnati Enquirer reported Jan. 5. -
New Jersey extends controversial state employee benefits contract with Horizon BCBS
New Jersey has extended its employee benefits contract with Horizon BCBS despite state officials and media reports alleging that previous contract terms have not been upheld by the payer, Bloomberg reported Jan. 4. -
UPMC Health Plan reducing ACA pharmacy network by 60%
UPMC Health Plan is adding a preferred pharmacy network to its ACA plans, reducing the number of pharmacies available to members by 60 percent, The Pittsburgh Post-Gazette reported Jan. 5. -
Aetna, Indiana health system extend contract, avoid split
Aetna and Munster, Ind.-based Community Healthcare System have agreed to a contract extension, avoiding a split that would have left Aetna commercial and Medicare Advantage members out of network. -
Aetna snags North Carolina state employee contract; BCBS loses out
Aetna will manage health insurance for more than 740,000 North Carolina state employees, winning a contract BCBS North Carolina has held for over 40 years. -
7 new payer contracts
As year-end deadlines approached, several payers and providers struck new deals to keep patients in-network. -
Despite revised contracts, Molina expects California Medicaid revenue will double
Although California is awarding more payer contracts to its Medi-Cal program, Molina Healthcare — who won big in the state's initial August 2022 award — is expecting its California Medicaid revenue will double. -
Regence BlueShield of Washington, Optum-owned clinics strike new contract
Regence BlueShield of Washington and Optum-owned Everett (Wash.) Clinic and Polyclinic have reached an agreement to keep 19,000 commercial members in-network. -
In major reversal, California awards additional Medicaid contracts
California is awarding more payers contracts to manage its Medicaid program, reversing course on contract awards that could have forced two million Medi-Cal members to switch insurance. -
BCBS Tennessee, Methodist Le Bonheur Healthcare split after failed negotiations
Memphis, Tenn.-based Methodist Le Bonheur Healthcare is out of network with Blue Cross Blue Shield of Tennessee after the sides were unable to reach a new agreement by Dec. 31, the Memphis Commercial Appeal reported Jan. 2. -
Cigna, ProMedica finalize contract
Cigna and Toledo, Ohio-based ProMedica have finalized an agreement to keep the health system's patients in network with the payer, ABC affiliate WTVG reported Dec. 29.
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