Mount Sinai and UnitedHealthcare Reach Insurance Deal

After months of stalled contract negotiations, Mount Sinai Health System, a leading New York City hospital system, and the health insurance giant UnitedHealthcare announced a deal on Tuesday that will keep Mount Sinai’s hospitals and doctors in network.

The deal was announced just days before Mount Sinai-affiliated doctors were due to be removed from UnitedHealthcare’s network, which would have forced tens of thousands of New Yorkers to switch doctors or risk paying out-of-network prices. Mount Sinai’s hospitals had already been removed from in-network coverage.

“UnitedHealthcare and Mount Sinai Health System have agreed to a new multiyear contract that restores network access to the health system’s hospitals for people enrolled in employer-sponsored and individual plans, including the Oxford Health Plan, effective immediately,” the insurer said in a statement. “The agreement also ensures continued access to Mount Sinai’s physicians.”

Thestalemate had left many New Yorkers scrambling to move their appointments earlier, before doctors were set to go out of network, or to find new doctors altogether. It was especially stressful for cancer patients at Mount Sinai or pregnant women who had planned to deliver at one of the system’s hospitals, doctors said.

New Yorkers with employer-based insurance are often accustomed to broad network coverage that give them significant choice of hospitals and doctors. But Mount Sinai’s negotiations with United raised the question of whether that might be changing.

At another major New York hospital system, NewYork-Presbyterian, patients with Aetna health insurance are at risk of having to pay out-of-network prices unless a contract is negotiated by March 31.

The negotiations between United and Mount Sinai were especially contentious because of a new dynamic: recent laws and regulations that required hospitals to publish far more information about rates than they had in the past. Mount Sinai concluded that United had long paid other leading hospital systems far more for many procedures — and decided to negotiate for substantially higher rates. United called Mount Sinai’s proposed increases “outlandish.”

In a message to Mount Sinai employees on Tuesday, hospital officials called the agreement an “enormous victory.”

“We were never asking to be the highest-paid system in the region — we were simply asking for fair payment for our physicians and hospitals and fewer denials for the outstanding care you deliver every single day,” according to the message from several top hospital officials, including the system’s chief executive officer, Dr. Brendan Carr. “The new contract achieves all of these goals.”

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