5 recent payer disputes, resolutions

A New York judge ruled on the future of New York City's controversial retiree Medicare contract after its rollout was put in limbo. At the same time, payers are working to lock in network contracts for the new year. 

Here are five recent disputes and resolutions involving payers:

1. Florida Blue extended its network agreement with Nashville, Tenn.-based Envision Healthcare for several years, securing access to over 6,000 physicians and specialists.

2. Anthem and Marietta, Ohio-based Memorial Health System extended their network agreement through 2025, surpassing Memorial Health System's previous agreement to be in network through September 2022. 

3. Aetna, Oscar Health and Wellfleet were tagged by the New York Financial Services Department for allegedly violating state and federal mental health parity laws. The payers collectively must pay $3.1 million in fines and reimbursements. 

4. A New York judge conditionally approved the rollout of New York City's retiree Medicare plan after issuing a temporary pause. The ruling gives retirees until March 31 to opt out of the new plan, which would result in a $200 monthly surcharge to keep their previous benefits. 

5. Blue Cross Blue Shield of Michigan and a subsidiary, the Accident Fund, received a labor complaint for requiring employees be vaccinated against COVID-19 and subsequently suspending those who refused to get vaccinated.

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