Dec. 31 deadlines are looming for some payer-provider contracts, while other disputes are dragging on and leaving patients out of network. Here are five updates on ongoing contract negotiations:
- Aetna and Allentown, Pa.-based Lehigh Valley Health Network will be out of network next year if a resolution is not reached by March, a break that could affect thousands of patients. The health system told patients Nov. 10 it would terminate its agreements with most Aetna plans after March 13, 2023, accusing the payer of refusing to pay for patients' care and denying or delaying care.
- Blue Cross Blue Shield of Illinois and Springfield, Ill.-based Springfield Clinic are still negotiating without a resolution in sight, nearly a year after contract negotiations between the two sides fell through. The number of affected patients is disputed by the two sides. BCBS Illinois says 55,000 patients are affected, while Springfield Clinic says the number is 110,000.
- UnitedHealthcare and Syracuse, N.Y.-based SUNY Upstate University Hospital will be out of network if the two sides are unable to reach a new contract before the current one expires Dec. 31. The dispute could leave 20,000 patients out of network with the hospital.
- Anthem Blue Cross Blue Shield and Wausau, Wis.-based Aspirus Health will be out of network if a new contract agreement is not reached by Dec. 31. Aspirus sent a letter to Anthem members Oct. 19, warning enrollees negotiations between the health system and Anthem were "stalled." The health system operates 17 hospitals across Wisconsin and Michigan, along with 75 clinics.
- Blue Cross Blue Shield of Mississippi and Jackson-based University of Mississippi Medical Center remain without a contract more than six months after the organizations went out of network with each other. Several weeks without progress led the state's insurance commissioner to suspend mediations indefinitely Oct. 11.