Anthem Blue Cross and Mount Sinai Health System Reach Agreement
A new agreement finalized late Monday between Anthem Blue Cross and Blue Shield and the Mount Sinai Health System will restore health insurance access for over 20,000 Long Island residents and around 90,000 New Yorkers, Anthem announced on Tuesday.
This dispute over insurance has led to disruptions in in-network care for Mount Sinai patients since January 1, with inpatient coverage ending as of March 1.
The deal allows patients to see Mount Sinai doctors at the system’s 17 locations on Long Island and to access hospitals like those in Oceanside and Manhattan. Mount Sinai officials indicated that access would be reinstated immediately.
The agreement also encompasses coverage for Medicaid, Child Health Plus, and Essential Plans.
Dr. Brendan G. Carr, CEO of the Mount Sinai Health System, stated, “We understand that this is a challenging time for both patients and healthcare providers, and we are happy that Anthem beneficiaries will once again have the opportunity to experience Mount Sinai’s exceptional care.”
The prior agreement lapsed on January 1, limiting in-network options for over 9,000 Mount Sinai physicians. A provision allowing continued care for some patients, including those with cancer, ended on March 31, forcing them to find alternative inpatient doctors.
Anthem representatives argued that Mount Sinai was pushing for price increases that surpass the inflation rate. In contrast, officials from Mount Sinai asserted that they sought increases equal to or below those of other local healthcare providers.
Additionally, Mount Sinai is attempting to address $450 million in historical debts and unpaid bills allegedly owed to Anthem.
In a statement on Tuesday, Anthem noted that the new contract incorporates “responsible price increases to make long-term cost trends easier to predict.”
The agreement also includes “measures to ensure hospital billing accuracy and appropriate care settings,” along with aligning healthcare costs “more closely with inflation and worker wages.”
