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2M Healthfirst members could lose coverage for major NYC hospital network this fall
By
Caroline Lewis
Published Sep 9, 2025
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Anadolu/Getty Images
By
Caroline Lewis
Published Sep 9, 2025
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Some 2 million New Yorkers insured by Healthfirst, one of the state’s largest Medicaid providers, are on the verge of losing coverage this fall for nearly a dozen hospitals in the NewYork-Presbyterian network as well as thousands of affiliated physicians — unless the two entities can agree by early November.
The insurer and hospital network have both posted notices online saying NewYork-Presbyterian medical centers and physicians at ColumbiaDoctors and Weill Cornell Medicine will go out of network for Healthfirst plans starting on Nov. 3. In addition to Medicaid plans for low-income residents, Healthfirst also offers other individual and family plans as well as Medicare Advantage insurance for older adults.
This isn’t the first time NewYork-Presbyterian has threatened to cut ties with a major insurer. The health system said it was on the verge of leaving Aetna’s network last year as the two negotiated over payment rates — but they ultimately inked a new deal just days before the old contract was set to expire.
In this case, however, Healthfirst said it already agreed on a new contract with NewYork-Presbyterian in November 2024 that was supposed to run through 2027. Then NewYork-Presbyterian abruptly notified the insurer it was terminating the contract “without cause” in July, Healthfirst said.
Angela Karafazli, a spokesperson for NewYork-Presbyterian, said there were outstanding issues with the terms of the contract that the two entities have been negotiating over for months.
“Having reached an impasse, we issued a notice of termination with the expectation that we would continue our negotiation, to come to an agreement,” Karafazli said.
In a post online, NewYork-Presbyterian wrote, “We are committed to negotiating with Healthfirst to reach an agreement that puts our patients first and allows them to continue to receive the high-quality care they have come to trust.”
Loren Riegelhaupt, a spokesperson for Healthfirst, said the insurer is also working toward a resolution, but added, “With a terminated contract, our options are limited.”
Riegelhaupt said Healthfirst is in the process of sending out notices about the impending coverage changes to members. Some New Yorkers affected by the split have heard about it in recent weeks through their doctors, online posts, or word of mouth, and are figuring out how to avoid losing access to care.
Sanya Bogandich, who is insured through Healthfirst, said she and her family have been receiving care from doctors affiliated with NewYork-Presbyterian since the early 2000s. Bogandich, 62, lives on the Upper East Side and has long visited an internist at nearby Weill Cornell to monitor a rare autoimmune disease known as Antiphospholipid syndrome, which can put patients at higher risk for blood clots.
“ I have been going there for a very long time. They have all of my files. They know me,” Bogandich said.
She said she’s unsure whether she should start looking for doctors affiliated with other hospitals or wait to see if the contract dispute between NewYork-Presbyterian and Healthfirst gets resolved.
Some Healthfirst members receiving care at NewYork-Presbyterian may be able to take advantage of state and federal laws around continuity of care to get in-network coverage after Nov. 2. These rules apply to patients who are pregnant, receiving ongoing treatment for complex conditions such as cancer, or who are scheduled for non-elective surgeries, among other circumstances.
Emergency care at NewYork-Presbyterian hospitals will also still be covered.
Tagged
Health and Science
new york city
new york presbyterian
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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