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Mount Sinai, UnitedHealthcare reach deal after leaving patients in limbo
By
Caroline Lewis
Published Mar 19, 2024
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Deb Cohn-Orbach/UCG/Universal Images Group via Getty Images
By
Caroline Lewis
Published Mar 19, 2024
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Mount Sinai and UnitedHealthcare say they have reached an agreement on a new contract after a monthslong dispute that disrupted coverage for thousands of patients.
All Mount Sinai facilities will be back in network with UnitedHealthcare and its subsidiary Oxford Health Plans effective immediately, according to the hospital system’s website. Coverage will continue uninterrupted for Mount Sinai-affiliated doctors, who otherwise would have gone out of network on Friday.
“We thank our members and customers for their support and patience throughout this process and are honored to continue supporting all of the people throughout New York who depend on us for access to quality and affordable health care,” United wrote in a statement online.
After Mount Sinai and United ended their contract at the end of last year, Mount Sinai hospitals immediately went out of network for some United customers, while others lost coverage this month. United then announced that it was going beyond hospital care and removing Mount Sinai doctors from its network as well.
The fracas over payment rates caused panic and confusion among patients, who were trying to figure out if and when they would have to switch providers. More than 80,000 people insured through UnitedHealthcare have visited a Mount Sinai hospital or doctor over the past year, according to the insurer.
“This is an enormous victory for our patients and for each of you who work so hard to provide the best possible experience and care for those we serve,” Mount Sinai officials wrote in an internal notice about the deal sent out on Tuesday.
A Mount Sinai spokesperson shared the statement with Gothamist.
A separate dispute still imperils insurance coverage for tens of thousands of other New Yorkers. Aetna and the New York-Presbyterian health system are trying to resolve contract talks by the end of the month, but say they're far apart on terms. If they don't reach to a deal, Aetna members could lose coverage for New York-Presbyterian’s 10 hospitals, its two large physician networks, and its array of specialty clinics in the coming months. Some types of care would end as soon as April 1.
The dispute between United and Mount Sinai centered on the hospital system’s proposed rate hikes. The insurer rejected them as “outlandish,” while Mount Sinai said they were necessary to cover costs and were in line with rates paid to competitors.
“We were simply asking for fair payment for our physicians and hospitals and fewer denials for the outstanding care you deliver every single day,” Mount Sinai officials said in the internal memo. “The new contract achieves all of these goals and will provide certainty for the next four years,” they wrote.
Statements from the hospital and insurer on Wednesday didn’t address the terms of their new contracts, or any agreed-upon rates.
This story has been updated to include information about a contract dispute between Aetna and New York-Presbyterian.
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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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