10 updates on payer-provider relations

Here are 10 recent articles posted by Becker's Hospital Review that concern payer-provider relationships:

1. UMass Memorial, UnitedHealthcare hit contract impasse
UMass Memorial Health Care patients with UnitedHealthcare insurance may face higher out-of-pocket costs if the insurer and the Worcester, Mass.-based health system can't agree on a new contract.

2. Mission, Cigna renew contract
Asheville, N.C.-based Mission Health and Cigna entered into a multiyear agreement that ensures Cigna's members have undisrupted access to Mission facilities and providers.

3. U of Mississippi Medical physician sues insurers for denying cancer treatment
A physician practicing at the University of Mississippi Medical Center in Jackson filed a lawsuit against his insurers for denying coverage of proton therapy to treat his brain cancer.

4. Highmark-UPMC skirmish opened doors in Pittsburgh's private Medicare market
While Pittsburgh-based rivals Highmark and UPMC battled over their contract, national payers creeped into the region's private Medicare market the dueling institutions previously dominated.

5. Harvard Pilgrim wants to ease health plan transitions    
Harvard Pilgrim Health Care, a health plan serving more than 3 million members, debuted a program Oct. 16 that aims to reduce disruption when consumers and employers switch health plans.           

6. UnitedHealth drops appeal of Supreme Court decision on alleged overpayments            
UnitedHealth Group dropped an appeal asking the Supreme Court to uphold a controversial billing tactic.

7. Massachusetts hospital, BCBS end feud          
New Bedford, Mass.-based Southcoast Health System and Blue Cross Blue Shield of Massachusetts agreed to a new four-year contract.

8. UnitedHealth drops Alabama hospitals from Mississippi managed care plans            
Mobile-based University of South Alabama hospitals will no longer be in UnitedHealthcare's Mississippi Medicaid managed care and children's provider networks.

9. Insurers move to cover controversial psychiatric drug tests           
More insurers are covering genetic tests for psychiatric medications despite federal warnings and questions surrounding the validity of the tests.

10. New Jersey officials reject Horizon BCBS' new claims review policy            
The New Jersey Department of Banking and Insurance rejected a proposal from Horizon Blue Cross Blue Shield of New Jersey that would have outsourced some claim reviewal and medical necessity determination to a third-party company.           

More articles on payers:
Humana to lay off 800+ employees
CMS delays start of primary care payment model
CEO of Texas Health Aetna out after 8 months

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