As of Aug. 1, non-emergency, scheduled elective services provided by Oklahoma-based Norman Regional Health System are no longer in network for Aetna members. The update affects commercial, Medicare Advantage and administrative-services-only plans, with Medicaid excluded. Norman Regional said negotiations had…
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Norfolk, Va.-based Sentara Health is seeking a 6.2% blended reimbursement increase from Anthem Blue Cross and Blue Shield of Virginia for 2027. The insurer countered with an approximately 1% decrease, according to Sentara Executive Vice President and Chief Administrative Officer…
University of Miami Health System has reached a multi-year agreement with UnitedHealthcare to maintain in-network access. Under the agreement, UHealth’s hospitals, facilities and physicians will remain in network for UnitedHealthcare’s employer-sponsored plans, its Florida Medicaid plan and its ACA plans.…
Payer policy changes that are not reflected in contracts are the leading source of revenue leakage for providers, according to a July 29 report from Trek Health in partnership with the Healthcare Financial Management Association. The report is based on…
Tacoma, Wash.-based MultiCare Health System has reached an agreement in principle with Premera Blue Cross, the health system told Becker’s July 29. While details of the contract are still being finalized, MultiCare said Premera commercial members will continue having access…
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Blue Cross and Blue Shield of North Carolina won the state’s third-party administrator and pharmacy benefit manager contracts for the state health plan effective Jan. 1, 2028. Blue Cross NC previously lost its TPA contract and challenged Aetna’s 2025 contract…
Wellpoint D.C., Elevance Health’s Medicaid subsidiary in the District of Columbia, will exit the district’s Medicaid managed care program effective Aug. 1. Enrollees currently with Wellpoint, formerly Amerigroup D.C., will be automatically reassigned to AmeriHealth Caritas starting Aug. 1, according…
Northwell Health and Fidelis Care are on track to end their contract July 15, a split the health system said will affect more than 240,000 patients across Medicaid, Medicare Advantage and Essential Plan coverage. Fidelis, part of Centene, previously issued…
Charleston, S.C.-based MUSC Health and Cigna have extended their current contract through Aug. 31 as they continue negotiations on a new agreement. The health system shared the update June 24. MUSC Health hospitals and physicians were expected to go out…
Montgomery, Ala.-based Jackson Hospital President and CEO John Quinlivan is hopeful that a solution can be reached to save the financially struggling facility as the clock ticks down to a potential July 1 closure. Jackson Hospital, which sought bankruptcy protection in February,…