When Thursday begins, thousands of Long Islanders insured by Anthem Blue Cross Blue Shield will no longer have visits at Mount Sinai medical offices covered.
Indianapolis-based Anthem’s contract with New York City-based Mount Sinai Health System expired Wednesday, according to both parties. At the heart of negotiations for a new contract were the rates Anthem pays Mouth Sinai.
Starting New Year’s Day, more than 9,000 Mount Sinai physicians, including those at 14 medical offices in Nassau and another three in Suffolk, will be considered out-of-network for those insured by Anthem, according to Mount Sinai’s website.
“Unfortunately, Anthem has stated that this will not be resolved before our commercial and Medicaid contracts expire,” Mount Sinai said in a statement to Newsday.
Anthem coverage at Mount Sinai hospitals, including Mount Sinai South Nassau in Oceanside, will continue for an extra 60 days in accordance with state law, Anthem said on its website.
Under continuity of care protections, Mount Sinai patients can continue to receive coverage from Anthem for ongoing treatments for cancer, pregnancy and other “serious and complex conditions,” according to the insurer’s website.
“Patients in active treatment will not lose access to their doctors,” Anthem said in an emailed statement to Newsday. “Anthem’s Continuity of Care protections ensure that members in an ongoing course of treatment will continue to receive care at in-network coverage levels. Qualifying conditions include medical, mental health, and substance use disorders.”
If the two sides fail to reach an agreement by Feb. 28, all Mount Sinai hospitals, including Mount Sinai South Nassau in Oceanside, will also be out of Anthem’s network as of March 1, Mount Sinai said in its statement.
Anthem currently insures about 90,000 New York residents, according to an Anthem spokesperson.
As of Nov. 30, 13,702 Nassau County residents and 6,951 Suffolk County residents were insured by Anthem through NY State of Health, according to the state health care marketplace.
The number of Long Islanders covered by Anthem’s Medicaid network was not immediately available Wednesday.
In its emailed statement, Anthem said: “While we have not been able to reach an agreement with Mount Sinai before tonight’s deadline, Anthem remains committed to affordable care and to protecting members’ access to needed treatment. We continue to work to retain Mount Sinai doctors and facilities in our care network.”
Mount Sinai, in its letter to patients, said only Anthem can approve continuity of care coverage.
“We have been trying to work with Anthem to make the continuity of care process as simple as possible for our patients, but so far, they have not been willing to partner with us on this,” the letter said. “If you believe you may be eligible for continuity of care, please contact Anthem directly at the number on the back of your insurance card.”
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