NYers Lose Mount Sinai Coverage Amid Insurance Dispute

NEW YORK CITY — Thousands of New York City patients no longer have insurance coverage for Mount Sinai hospitals, and soon will for the system's doctors if a long-standing cost dispute isn't resolved.

The medical system's hospitals and outpatient facilities went off the UnitedHealthcare and Oxford Health Plans networks Friday — a potentially devastating development, for which both sides have blamed the other.

The move came after Mount Sinai officials pressed UnitedHealthcare for more pay, a demand they characterized as reasonable, but that insurers deemed "outlandish."

The impasse soon won't just affect hospital patients — if an agreement isn't soon struck, Mount Sinai-associated physicians will be removed from UnitedHealthcare's network March 22, officials said.

“UnitedHealthcare is blatantly misrepresenting the facts," said Lucia Lee, Mount Sinai's vice president of public affairs, in a statement.

"Mount Sinai is simply asking to be paid fairly, but still well below our higher paid competitors for the outstanding care we provide. Out of dedication to our patients, we are committed to remaining the best value among the top-ranked systems in New York City. But we refuse to allow UnitedHealthcare to continue to pay us a full 30-50% less than our competitors."

UnitedHealthcare representatives, for their part, swiped at their Mount Sinai counterparts, whom they said proposed two different contracts with price hikes that would increase health care costs by $574 million and $927 million.

"All of Mount Sinai's proposals would make its hospitals and physicians the most expensive by a considerable margin in New York City," a statement from UnitedHealthcare states.

"We continue to await a realistic proposal from Mount Sinai that's affordable and sustainable for New Yorkers and employers."

New York City is home to six Mount Sinai hospitals that are affected by the changes Friday. All the facilities that will be out of network are:

• Mount Sinai Beth Israel
• Mount Sinai Brooklyn
• Mount Sinai Morningside
• Mount Sinai Queens
• Mount Sinai South Nassau
• Mount Sinai West
• New York Eye and Ear Infirmary of Mount Sinai
• The Mount Sinai Hospital

The dispute and associated finger pointing stems from May 2023, when Mount Sinai officials sought a new agreement with UnitedHealthcare.

The system leaders effectively wanted to be paid more, and contended that United routinely denied proper coverage to patients in order to reap benefits for shareholders. Mount Sinai representatives have also contended that insurers' accusation that New Yorkers will bear $600 million more in costs under the system's proposals are patently false.

Both sides have stressed that emergency care will continue to be provided in-network.