15 recent payer-provider contract disputes, resolutions

These 15 contract resolutions and dissolutions occurred between payers and providers since Oct. 1, beginning with the most recent.

1. NewYork-Presbyterian: Empire BCBS demanding $200M payment cut
Contract negotiations between New York City-based NewYork-Presbyterian and Empire BlueCross BlueShield have stalled ahead of a Dec. 31 deadline.

2. Tenet, Cigna hit contract snag for Memphis hospitals: 6 things to know
Cigna health plan members may no longer have in-network access to Dallas-based Tenet Healthcare's Memphis, Tenn.-based facilities if the two parties can't agree on a contract renewal by Dec. 31.

3. Envision maps out UnitedHealthcare dispute in new site: 5 things to know
Nashville, Tenn.-based Envision Healthcare launched a new website outlining where its negotiations with UnitedHealthcare stand.

4. Duke LifePoint physicians, UnitedHealthcare feud over rates: 4 notes           
Brentwood, Tenn.-based Duke LifePoint Healthcare and UnitedHealthcare are attempting to negotiate a new contract for some of the health system's employed physicians before a Jan. 1 deadline.

5. 950 ProMedica physicians may go out of network with Aetna           
Toledo, Ohio-based ProMedica Physician Group may leave Aetna's provider network if a contract dispute between the two organizations persists.

6. Looming Aetna, Mount Sinai Medical Center split could affect 100K        
More than 100,000 patients could be affected if a price dispute between Aetna and Miami-based Mount Sinai Medical Center goes unresolved.

7. Piedmont Healthcare, Cigna reach value-based agreement           
Atlanta-based Piedmont Healthcare and Cigna extended their contract multiple years under a new value-based agreement.

8. NJ community hospital settles with BCBS after alleging it was pushed out of market        
Ridgewood, N.J.-based Valley Hospital settled with Horizon Blue Cross and Blue Shield of New Jersey the day before a trial was set to begin on allegations that the insurer pushed smaller community hospitals out of the market.

9. Idaho hospital's ER physicians ink retroactive agreement with BCBS       
Pocatello, Idaho-based Portneuf Medical Center emergency room physicians are back in network with Blue Cross of Idaho.

10. Mississippi health system blames Humana split on improper denials           
Tupelo-based North Mississippi Health Services notified patients it is ending a provider network agreement with Humana's Medicare Advantage plans due to frequent denials.

11. WellCare inks value-based payment agreement with 14K-physician group        
WellCare Health Plans expanded its value-based provider network to include agilon health, a Long Beach, Calif.-based group with 14,000 physicians.

12. The 10 UPMC hospitals going out of network with Highmark in 2019           
A state-brokered consent decree between Pittsburgh rivals Highmark Health and UPMC expires June 30, 2019. After that date, Highmark Medicare Advantage members will be unable to access several UPMC providers and hospitals at in-network rates.

13. OhioHealth, Anthem impasse to affect 11K Medicare patients           
About 11,000 patients could lose access to OhioHealth due to a contractual issue between the Columbus-based health system and Anthem Blue Cross and Blue Shield's Medicare Advantage plan.

14. Cigna, Hartford HealthCare reach 3-year agreement        
Hartford (Conn.) HealthCare has reached a three-year network agreement with Cigna for the system's six hospitals, effective Nov. 1.

15. Savannah's Memorial hospital, Blue Cross renew network deal            
Savannah, Ga.-based Memorial Health University Medical Center has renewed its network agreement with Anthem Blue Cross and Blue Shield of Georgia.

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