New York City has proposed a new self-funded health plan administered by EmblemHealth and UnitedHealthcare for municipal employees, pre-Medicare retirees and their dependents. If approved by city regulators, the new plan would be effective on Jan. 1, according to an…
Payer Contracting
Brewer, Maine-based Northern Light Health said it has agreed to engage in mediation with Anthem Blue Cross Blue Shield in a “last-ditch effort” to resolve a contract dispute between the parties. Northern Light’s Aug. 26 announcement comes after the system…
Baltimore-based Johns Hopkins Medicine went out of network with UnitedHealthcare on Aug. 25 after the parties were unable to agree on a new contract. The split comes after the two sides negotiated for eight months and extended their current…
Summa Health will no longer schedule appointments for people with out-of-network and non-contracted insurance plans, effective Sept. 1. The policy includes services provided by the system’s medical group, walk-in services at its urgent care centers, and laboratory and radiology services.…
Northern Light Health says it has “made the difficult but necessary decision” to end its relationship with Anthem Blue Cross and Blue Shield, citing payment delays, administrative burdens, and what it calls misleading public narratives from the insurer. The Brewer,…
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Miami-Dade County Commissioners voted Aug. 13 to replace AvMed with Aetna to administer health benefits for more than 31,000 employees, the Miami Herald reported. AvMed held the contract since 2007 and has filed a legal challenge over the bidding process. …
The University of Alabama at Birmingham Health System and UnitedHealthcare finalized a long-term contract, AL.com reported Aug. 9. “The UAB Health System and UnitedHealthcare have finalized a new three-year health insurance agreement, ensuring continued access to high-quality care for patients…
Cigna Healthcare and St. Louis-based BJC Health System reached a new agreement to keep the system’s patients in-network with the payer, the St. Louis Business Journal reported July 31. The new agreement went into effect Aug. 1, according to the…
CMS has granted a special Medicare enrollment period for individuals affected by the July contract disagreement between UnitedHealthcare Medicare Advantage and Providence, R.I.-based Brown University Health. CMS determined that the removal of the system’s hospitals from UnitedHealth’s MA network was…
Baltimore-based Johns Hopkins Medicine and UnitedHealthcare are at odds over prior authorization requirements as they negotiate a new contract, The Baltimore Sun reported July 29. The sides have been negotiating a new contract for seven months and their current agreement…