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Medical care for thousands of cancer patients in the New York area is at risk of facing disruption due to an ongoing contract dispute between UnitedHealthcare (UHC), the insurance arm of UnitedHealth Group (NYSE:UNH), and Sloan Kettering Cancer Center.
As a result of the dispute, some of MSK’s services are considered out-of-network for members enrolled in UHC’s commercial plans, meaning they will be forced to bear higher medical costs or find an alternative in-network provider.
The impasse came after MSK and UHC failed to reach an agreement by a June 30 deadline, making the former’s outpatient centers and physicians out of network for those enrolled in UnitedHealthcare’s (NYSE:UNH) commercial plans from this month.
However, MSK’s hospital services will continue to be in-network for patients with UHC’s fully insured coverage plans through Aug. 31 as part of New York’s 60-day “cooling off” rule.
The cooling-off period doesn’t apply to self-funded or level-funded commercial plans, which are not regulated by state-mandated insurance laws. The dispute is not related to UNH’s Medicare Advantage plans.
As for reasons for the standoff, Memorial Sloan Kettering and UHC pointed fingers at each other.
“We urge UHC to return to the negotiating table with a proposal that puts patients first and keeps continued access to the world-class cancer care they rely on and deserve,” the cancer hospital said in a statement.
UHC said MSK is demanding an average price hike of nearly 30% for its hospital, facilities, and physicians. “Our top priority is to reach an agreement that is affordable for consumers and employers while providing continued network access to MSK,” the company added.