Concerns Rise for Patients at Memorial Sloan Kettering
Approximately 20,000 patients at Memorial Sloan Kettering (MSK) are facing potential loss of access to essential medical care due to contract negotiations with UnitedHealthcare (UHC), a major health insurance provider.
Both parties are working towards finalizing new reimbursement contracts by the end of June. However, patients in need of critical care are left anxious about the possibility of being cut off from their providers come July 1, assuming no agreement is made by June 30.
Lee Kassler, a patient from Plainview, Long Island, expressed feeling “distrust” and “shock” upon hearing that he might lose access to his treatment facility. “It’s just filled with anxiety, sadness, stress, and all those emotions that came rushing back when I was diagnosed with cancer,” he mentioned. Kassler, who has been battling a rare and incurable stomach cancer since 2022, also stated he has “110%” confidence in MSK and can’t imagine seeking care anywhere else for such a serious matter.
Officials at MSK are advocating for increased reimbursement rates, arguing that the annual increases in the past five years don’t align with the rising operational costs hospitals are facing.
In a statement, they highlighted their commitment to securing a long-term deal with UHC that reflects the actual costs of providing cancer care. UHC, on the other hand, asserted that the highly regarded cancer center is seeking a 35% increase in reimbursement rates over the next three years.
UHC further mentioned that they have proposed a significant fee increase that would keep payments to MSK at levels above those designated for other National Cancer Institute facilities in the New York City area.
MSK’s chief medical officer, Cardinale Smith, countered this, arguing that the offers from insurance companies are not sustainable for the healthcare provider. He noted the importance of prioritizing patient care during these negotiations.
With the possibility that over 19,000 patients, including Kassler, might experience disruptions in their treatment, the situation is significant. MSK has previously navigated similar contract disputes with insurance companies like Anthem and Cigna.
If an agreement isn’t reached by June 30, New York law mandates a cooling-off period, which will allow some patients to continue receiving in-network care until the end of August. This grace period primarily affects patients holding fully insured UnitedHealthcare or Oxford hospital plans, and options for applying for continuity of care may also be available to ensure some level of support.
As Kassler’s birthday approaches, he expressed his hope for positive news regarding the contract. “The best present was my grandson,” he said, “but the second best would definitely be some resolution to this situation.” He emphasized his intent to continue receiving care at MSK in the long run.
