Payer Contracting

Portland-based MaineHealth's flagship hospital will exit the Anthem insurance network in January, citing more than $70 million in unpaid claims over the past three years as justification for the split, The Portland Press Herald reported April 6. 

Thousands of UnitedHealthcare beneficiaries are now out of network at Fort Lauderdale, Fla.-based Broward Health after the two parties failed to reach a new contract by the April 1 deadline. 

The University of Vermont Health Network has agreed to commercial contract terms with UnitedHealthcare. 

Vermont state officials say 5,000 UnitedHealthcare members are at risk of losing coverage within the University of Vermont Medicine Health Network, up from the 3,000 estimated earlier this month, according to VTDigger.

Blue Cross and Blue Shield of Mississippi is expected to drop University of Mississippi Medical Center hospitals, clinics and physicians from its network April 1 following a contract dispute.

Oregon has agreed to pay $22.5 million to settle a years-long legal dispute with a company that provided care to Medicaid patients, according to a March 26 Salem Statesman Journal article. 

Baton Rouge (La.) General plans to end its Medicare Advantage contract with Humana if a new deal is not reached by May 3, The Advocate reported March 16. 

Here are six payer-provider contracting disputes and settlements that have occurred since Jan. 1:

BlueCross BlueShield of Texas and Houston-based Memorial Hermann said March 11 they reached a new agreement to keep 100,000 members in-network.

The Green Mountain Care Board is urging the Burlington-based University of Vermont Medicine Health Network to sort out its contract dispute with UnitedHealthcare, which could leave about 2,900 patients at UVM and its affiliates without coverage, VTDigger reported March 8.