Payer Contracting

Centene's Texas-based subsidiary, Superior HealthPlan has been awarded a six-year contract to continue providing healthcare coverage for foster care youths through the State of Texas Access Reform Health Medicaid program. 

BlueCross BlueShield of Montana has been awarded a three-year contract to administer the state's employees health plan for 28,000 people.

Anthem Blue Cross and Blue Shield said it is reviewing its options after a panel of Kentucky appellate court judges upheld the state's 2020 managed care contract awards, the Louisville Courier Journal reported Sept. 15. 

Dayton, Ohio-based managed care organization CareSource is partnering with Texas' largest federally qualified health center with plans to participate in the procurement process for Medicaid contracts in two counties. 

With new or additional California Medicaid contracts in the offing, Molina Healthcare will add 1.4 million enrollees, mostly at Centene subsidiary HealthNet's expense, the Los Angeles Business Journal reported Sept. 12. 

Philadelphia-based Health Partners Plans is expanding its Medicare Advantage coverage into Gloucester County, N.J., The Philadelphia Inquirer reported Sept. 12. 

Raleigh, N.C.-based WakeMed has been out of network with UnitedHealthcare since June 1, and while contract negotiations are ongoing, a hospital spokesperson told CBS affiliate WNCN Sept. 8 they are "not confident in a quick resolution." 

Johns Hopkins will go out of network with CareFirst BlueCross BlueShield on Dec. 5 if the two sides are unable to reach a new contract, The Baltimore Sun reported Sept. 8. 

Highmark Blue Shield will become the new health benefits provider for the 39,000 people employed by Penn State starting next year, the Daily Collegian reported Sept. 7.

From Aetna to Anthem, several in-network contracts have been terminated between payers and providers this year, while others are on the verge of the same: