7 recent payer, provider contract disputes, resolutions

These seven contract resolutions and dissolutions occurred between payers and providers since mid-January, beginning with the most recent:

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1. UPMC to litigate over Highmark consent decree
Pittsburgh-based UPMC will fight a petition filed Feb. 7 by the Pennsylvania Attorney General’s office seeking to modify a consent decree between UPMC and Pittsburgh-based Highmark that is set to expire June 30.

2. Sutter Health, Anthem hit contract snare           
Sacramento, Calif.-based Sutter Health and Anthem Blue Cross of California are in a disagreement over rates.

3. Trinity Health, Humana sign in-network agreement for 7 hospitals           
Livonia, Mich.-based Trinity Health and Humana said Jan. 22 they reached a new agreement, which is currently in effect.

4. WellStar, Anthem to let contract expire            
Marietta, Ga.-based WellStar Health System and Anthem will let an in-network contract expire for Anthem members with ACA exchange coverage.

5. 5 health systems sign landmark deal with BCBS of North Carolina           
Five health systems in North Carolina agreed to share risk under a new reimbursement model with Blue Cross and Blue Shield of North Carolina.

6. Kansas hospital to leave Aetna’s managed care network: ‘They just would not negotiate’       
Emporia, Kan.-based Newman Regional Health will no longer be in network with Aetna Better Health, the health insurer’s managed Medicaid product.

7. Anthem latest insurer to ink agreement with Tenet           
Dallas-based Tenet Healthcare and Anthem Blue Cross signed a new multiyear agreement, the organizations said Jan. 16.

More articles on payer issues:
Humana CFO says Trump’s drug proposal will raise premiums
Utah may unwind voter-approved Medicaid expansion
UnitedHealth updates opioid policy

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