Providers ranging from large health systems to independent practices have recently gone out of network with major payers:
Optum joins Aetna in dropping Cerebral
Optum is canceling in-network services with mental health startup Cerebral in August after the San Francisco-based company received a federal subpoena May 4 related to possible violations of the Controlled Substances Act. Aetna also canceled its contract with the company, effective Aug. 21.
Maine physician practice to drop Anthem
Portland, Maine-based Fore River Urology terminated its contract with Anthem, effective Aug. 1. Medicare Advantage patients will no longer be in network starting Sept. 1. The disagreement stems from reimbursement rate negotiations. The provider had 10,000 patients who have been covered by Anthem for the last three years.
UnitedHealthcare, WakeMed terminate contract
Raleigh, N.C.-based WakeMed is no longer a part of the UnitedHealthcare network as of June 1 due to a contract impasse over reimbursement rates. The move is expected to leave 20,000 WakeMed patients out of network.
OU Health out of network with UnitedHealthcare; negotiations ongoing
Oklahoma City-based OU Health went out of network with UnitedHealthcare on May 1 amid a disagreement over reimbursement rates, though negotiations are ongoing. The move means thousands of UnitedHealthcare members cannot receive covered care at OU Health facilities.