Thousands of Memorial Sloan Kettering cancer patients could lose access to life-saving treatments in 2025 because of an ongoing contract fight with insurance giant Anthem Blue Cross Blue Shield.
MSK leadership said Wednesday it was “not confident” a deal would be reached between the two sides before their current contract expires on Jan. 1, 2025 – which would push some patients out of network and force them to drop the treatments or face impossibly high medical costs.
“I feel like once you have cancer … you live scan to scan,” said teacher and mother-of-four Carrie Regan, 41, who called the thought of losing care at MSK “crippling.”
The Hudson Valley resident was diagnosed with ovarian cancer in August 2023 and has been cancer-free since March — but she still goes for monthly checkups and said she has been frustrated by the lack of answers from Anthem.
“So on top of that anxiety now we have this level of anxiety that like what am I gonna do, who am I going to see,” Regan added.
MSK and the insurer are at loggerheads over the rate of reimbursement Anthem would give the medical institution — with the hospital’s chief financial officer accusing Anthem of putting “profit ahead of patient care.”
About 22,000 active patients could be affected by the potential impasse, according to MSK.
Overall, the hospital treated 71,233 patients in 2023.
A New York law requires current MSK patients under Anthem to receive in-network care until March 1 of next year so there is still time for the two sides to work out a deal following the Jan. 1 deadline.
“While we are working overtime to negotiate in good faith with Anthem to resolve this dispute for the patients who rely on us, Anthem does not appear interested in fair resolution,” hospital CFO Mike Harrington said in a scathing statement to The Post.
Anthem painted a more optimistic tone in a statement to The Post, saying the company is “confident we will reach an agreement with Memorial Sloan Kettering (MSK) as we continue to negotiate in good faith.”
The health insurance behemoth also claimed it was offering “generous” rate hikes to MSK.
“Anthem recently offered MSK generous payment rate increases, and we are awaiting their response in hopes that we can reach a resolution,” an Anthem spokesperson said in an email.
“Even as MSK has demanded drastic price hikes that would dramatically increase prices for MSK patients covered by Anthem and their employers, we have recently reached collaborative agreements with several other prestigious New York City health systems and continue to believe we will do the same with MSK.”
The impasse comes as health insurance companies have faced heightened scrutiny following the cold-blooded murder of UnitedHealthcare CEO Brian Thompson on a Manhattan street on Dec. 4.
Anthem faced heat earlier this month when it emerged the insurance company was going to place limits on the amount of time it covers for anesthesia while patients are under the knife, but quickly reversed course after fierce public outrage.
“Whether it’s an ill-advised policy to deny anesthesia coverage for surgical patients or refusing reasonable reimbursement rates for the most cost-effective cancer care provider in the northeast, Anthem continues to show it puts profit ahead of patient care,” Harrington, the CFO, said Wednesday.
MSK contended that Anthem has underpaid MSK for years at a 34% lower rate than other National Cancer Institute-Designated Cancer Centers in Manhattan.
The rate increase proposed by MSK would mean the hospital is reimbursed at least 10% less compared to similar medical centers, Harrington said.
“This isn’t a matter of wanting better reimbursement, it’s a matter of needing better reimbursement to continue delivering the best lifesaving care for patients who experience a cancer diagnosis,” he added.
