Negotiations between Mount Sinai Health System and Anthem Blue Cross Blue Shield failed, resulting in thousands of patients in New York losing in-network care.

Anthem officials said in a statement that the sides reached an agreement and a contract was ready to go. At the last minute, Mount Sinai refused to move forward. Mount Sinai stated that Anthem refused to commit to contract provisions designed to protect patients from excessive denials, delayed determinations, and prolonged administrative disputes.

Both parties have indicated they are willing to continue negotiations.

Source: CBS News

The provider contract between Anthem and Mount Sinai for Medicare Advantage plans is terminating on December 31, 2025. The parties remain in negotiation for all other types of plans offered by Anthem, including employer-sponsored group plans. If no agreement is reached, they will also go out-of-network on December 31, 2025.

Per provisions in New York law, if the contract lapses, then physicians and providers go out of network immediately. However, there is a 60-day “cooling off” period for hospitals, meaning that the hospitals themselves would remain in-network through February 28, 2026.

Both Mount Sinai and Anthem have published informational sites for affected patients.

Sources: Anthem, Mount Sinai