Aetna and Seattle-based UW Medicine facilities and physicians went out of network on June 1. Aetna’s commercial and Medicare Advantage members have lost in-network coverage at UW because no contract agreement was reached. There will be no impact to provider…
Payer Contracting
Cincinnati-based Bon Secours providers and facilities in South Carolina are facing a network split with UnitedHealthcare. If an agreement is not reached before July 1, the two organizations will be out-of-network across commercial, ACA, Medicare Advantage, and veteran plans. Some…
Contract disputes between insurers and health systems are down in 2025 compared to the second half of 2024. According to data from FTI Consulting, there were 133 total disputes in 2024, compared to 86 in 2023 and 51 in 2022.…
Blue Cross Blue Shield of North Carolina is seeking sanctions against LifeBrite Community Hospital of Stokes (N.C.) in a longstanding legal dispute that centers around allegations of fraudulent billing practices. The dispute began in 2018 when LifeBrite accused BCBSNC of…
Arizona has awarded Medicaid long-term care contracts to four managed plans after a yearlong dispute process. UnitedHealthcare, Centene, Banner-University Care Advantage and Mercy Care will manage the Arizona Long Term Care System-Elderly and/or Physically Disabled program, according to a May…
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Aetna has snagged a contract to manage healthcare benefits for more than 150,000 Pennsylvania state employees and their dependents. The Pennsylvania Employees Benefit Trust Fund selected Aetna to provide coverage to its employees and their dependents, and for around 11,000…
Nevada plans to award contracts to five insurers to manage the state's Medicaid program through 2029.
Illinois has awarded dual special needs contracts to Humana, Molina Healthcare, Centene's Meridian and Aetna.
Bon Secours Mercy Health and Cigna Healthcare will be out of network across eight Virginia hospitals on April 1.
Aetna and the University of Texas (Galveston) Medical Branch are back in network after a four-year split.