Mount Sinai and UnitedHealthcare reach insurance deal

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

The deal was announced just days before Mount Sinai-affiliated physicians were set 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. The hospitals on Mount Sinai had already been removed from network coverage.

“UnitedHealthcare and Mount Sinai Health System have agreed to a new multi-year contract that will restore 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 guarantees continued access to Mount Sinai physicians.”

The The standoff had many New Yorkers wanting to reschedule their appointments sooner, before doctors were about to leave their networks or find new doctors altogether. It was especially stressful for cancer patients at Mount Sinai or pregnant women planning to give birth at one of the system’s hospitals, doctors said.

New Yorkers with employer insurance are often accustomed to broad network coverage that gives them a wide choice of hospitals and doctors. But Mount Sinai’s negotiations with United raised questions about whether that could change.

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

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

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

“We never asked to be the highest-paying system in the region – we simply asked for fair pay for our doctors and hospitals and fewer denials for the excellent care you provide every day,” the post from several top hospitals. officials, including the system’s CEO, Dr. Brendan Carr. “The new contract achieves all these objectives.”