Payer Contracting

Carle Health in Urbana, Ill., said it won't commit to treating Aetna Medicare Advantage members, the only health plan offered to Illinois state retirees, until it has a contract with the insurer, The News-Gazette reported Sept. 28.

The Nebraska Department of Health and Human Services has selected three health plans to administer its Medicaid managed care program.

BayCare Health System paused all elective surgeries and procedures for Florida Blue members Sept. 22 as the expiration date for the in-network contract between the two organizations approaches, WFTS reported.

Harlingen, Texas-based direct primary care provider Frontier Direct Care has chosen Flume Health to help launch its new health plan. 

From an impending expired contract between BCBS and Texas Health Resources to Penn State swapping Aetna for Highmark to administer employee benefits, these are five recent payer-provider contract breaks:

Blue Cross and Blue Shield of Mississippi and Jackson-based University of Mississippi Medical Center have yet to reach a new contract more than four months after the sides agreed to a mediator, Mississippi Today reported Sept. 20.  

Blue Cross and Blue Shield of Texas and Farmers Branch-based Southwestern Health Resources will have no in-network contract with each other after Oct. 3 without a new agreement, WFAA reported Sept. 20.

Aetna has canceled a contract with its vendor that provides transportation to low-income seniors in Ohio following complaints from beneficiaries and the state about no-show rides, WCPO reported Sept. 19.

Hollister, Calif.-based Hazel Hawkins Memorial Hospital's contract with Anthem Blue Cross has been terminated, NBC affiliate KSBW reported Sept. 19. 

Amarillo, Texas-based Baptist St. Anthony Health System will go out of network with Blue Cross and Blue Shield of Texas on Dec. 7 if the sides are unable to agree on a new contract, ABC affiliate KVII reported Sept. 19.