17 payer, provider contract disputes, resolutions so far in 2017

Here are 17 contract resolutions and dissolutions that occurred between payers and providers since Jan. 1, beginning with the most recent.

1. Grady Memorial Hospital, BCBS of Oklahoma reach in-network agreement
Chickasha, Okla.-based Grady Memorial Hospital reached a preferred provider organization agreement with Blue Cross and Blue Shield of Oklahoma.

2. Northwest Healthcare, UnitedHealthcare negotiations stall as contract termination looms
Tucson, Ariz.-based Northwest Healthcare and UnitedHealthcare in Minnetonka, Minn., reached a contract impasse that could affect thousands of patients' in-network access to Northwest's services by May 1.

3. Eastern Idaho Regional Medical Center, BCBS of Idaho reach agreement
Idaho Falls-based Eastern Idaho Regional Medical Center and Blue Cross of Idaho in Meridian signed a contract in March to provide in-network coverage to certain BCBSI policyholders seeking emergency and referred services at the medical center.

4. Tenet, BCBS of Texas sign multi-year agreement
Dallas-based Tenet Healthcare inked a multi-year contract with Richardson-based Blue Cross and Blue Shield of Texas ahead of the agreement's April 15 termination date. 

5. Children's Minnesota dumps contract with BCBS
Minneapolis-based Children's Minnesota terminated its contract with Eagan-based Blue Cross and Blue Shield of Minnesota, a decision that may result in more than 70,000 patients losing in-network access to the hospital's services.

6. Methodist Le Bonheur Healthcare, Humana reach network agreement
Memphis, Tenn.-based Methodist Le Bonheur Healthcare and Louisville, Ky.-based Humana inked an agreement to allow the insurer's Medicare Advantage members to access the health system at in-network rates.

7. Prime Healthcare Services rescinds plans to terminate Anthem contract
Ontario, Calif.-based Prime Healthcare Services will remain in-network with Anthem Blue Cross after backtracking on plans to end its contract with the Indianapolis-based insurer hours after the decision was publicized.

8. Bon Secours St. Francis Health System, UnitedHealthcare resolve contract impasse
Greenville, S.C.-based Bon Secours St. Francis Health System and Minnetonka, Minn.-based UnitedHealthcare extended their previously terminated contract through June 30 to avoid a lapse in in-network coverage for approximately 10,000 patients.

9. Integrity Health clinics resolve BCBS of Minnesota contract dispute
Eagan, Minn.-based Blue Cross and Blue Shield of Minnesota reached a separate contract with each of Integrity Health Network's 20 affiliated clinics, avoiding the clinics' scheduled Feb. 1 exit from the insurer's provider network.

10. Priority Health, McLaren partner to expand healthcare access in Michigan
Grand Rapids, Mich.-based Priority Health and Flint, Mich.-based McLaren Health Care agreed to add McLaren hospitals and physicians to the Priority Health network.

11. Grady, Aetna reach new contract after 6 months of talks
Atlanta-based Grady Health System and Hartford, Conn.-based Aetna agreed to a new contract to keep all Grady hospitals and physicians in Aetna's network. 

12. University of Maryland physician group, Aetna ink 3-year partnership
Hartford, Conn.-based Aetna and a physicians group at the University of Maryland in College Park agreed to coordinate patient care to enhance patient outcomes while reducing healthcare expenses. 

13. BCBS of Western New York, Roswell Park Cancer Institute ink agreement
Buffalo-based BlueCross BlueShield of Western New York and Roswell Park Caner Institute in Buffalo, N.Y., reached a three-year agreement to continue in-network access to the institute and its affiliated physicians for the insurer's policyholders.

14. CVS says it was not its 'desire or decision' to leave BCBS of Alabama pharmacy network
CVS Pharmacy said it was not its "desire or decision" to leave the Blue Cross and Blue Shield of Alabama pharmacy network, which provides coverage for 390,000 policyholders.

15. BCBS of South Carolina discontinues out-of-state coverage for Blue Essential policyholders
The majority of BlueCross BlueShield of South Carolina Blue Essentials policyholders will no longer have access to out-of-state healthcare services at in-network rates, effective Jan. 1.

16. Humana, Boca Raton Regional Hospital renew contract
Boca Raton (Fla.) Regional Hospital and Louisville, Ky.-based Humana renewed their contract, allowing Humana policyholders to access the hospital's services at discounted rates.

17. BCBS of Florida, Retreat Premier Addiction Treatment network for services
Jacksonville, Fla.-based Blue Cross and Blue Shield of Florida networked with Retreat Premier Addiction Treatment Centers in Palm Springs, Fla., to provide policyholders access to addiction treatment services. 

 

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