10 updates on payer-provider relationships

Here are 10 recent updates on partnerships, disputes and policy changes affecting relationships between payers and providers: 

1. Minneapolis-based Allina Health and Blue Cross and Blue Shield of Minnesota inked a six-year contract that will help stabilize revenue for providers and support care models focused on improving outcomes.

2. Aetna Health of California must stop using national standards to deny payment for emergency room claims, the California Department of Managed Health Care ordered.

3. BlueCross BlueShield of Tennessee attorneys sent private data firm ClaimInformatics a letter warning that the insurer is contemplating suing ClaimInformatics over a report that found the Tennessee health insurance program approved $17.6 million in provider overcharges. The insurance program contracts with BCBS of Tennessee and Cigna to administer the plan. 

4. UnitedHealthcare is changing which medication for HIV prevention it considers a covered option for members.

5. Centene Corp. and its subsidiaries underpaid a group of emergency room physicians who are part of TeamHealth, according to a verdict.

6. Health insurer startup Oscar will run a Medicare Advantage plan with two health systems in Florida.

7. Cleveland Clinic and Aetna are forming an accountable care organization that includes the launch of a co-branded insurance plan designed for employers in Northeast Ohio and expanded access to the health system for second opinions and heart care. 

8. Anthem and Quest Diagnostics will collaborate on outcomes-based programs under a new partnership.

9. UnitedHealthcare will be replacing paper checks with electronic payments throughout the rest of this year.

10. A radiology lab in New Jersey sued Cigna over reimbursement for COVID-19-related services.

More articles on payers:
Aetna fined for denying ER claims in California
BCBS of Tennessee threatens to sue data firm over report finding provider overcharges
CMS waives Medicare requirements for hospitals affected by Hurricane Laura

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