5 recent payer-provider contract terminations

From several disagreements over reimbursement rates to millions in unpaid claims, these five contracts between payers and providers were recently terminated:

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Maine Medical Center exits Anthem network: The flagship hospital for Portland-based MaineHealth will exit the Anthem coverage network in January 2023, citing $70 million in unpaid claims. It is unclear how many beneficiaries will be affected.

BCBS drops University of Mississippi Medical Center: BCBS Mississippi removed UMMC’s 200 hospitals and clinics from its network on April 1. The Jackson, Miss.-based provider had requested higher reimbursement rates from the payer. In the last 18 months, over 50,000 patients with a BCBS plan received care at a UMMC facility.

UnitedHealthcare drops Broward Health: The Fort Lauderdale, Fla.-based provider was removed from UnitedHealthcare’s network on April 1 after requesting higher reimbursement rates, affecting thousands of members. 

BCBS Texas and Memorial Hermann sever contract: The payer and Houston-based Memorial Hermann did not renew their contract on February 28, citing a disagreement on reimbursement rates. About 3,000 physicians and 265 facilities are now out of network for 100,000 beneficiaries.

BCBS Illinois drops Springfield Clinic: BCBS Illinois removed Springfield Clinic from its network on November 17 after the two failed to agree on reimbursement rates. The move affects 100,000 members across 600 clinic facilities.

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