From UHC/Oxford:

An update on our negotiation with Mount Sinai Health System 2.15.2024

As part of our commitment to keeping you updated on the negotiation, we want to provide you the latest information, as well as an important update, regarding our contract with the majority of Mount Sinai’s physicians.



We want to provide you the following important updates regarding the participation status of the majority of Mount Sinai’s physicians:

• This negotiation initially only impacted Mount Sinai’s hospitals. However, our credentialing plan requires that the physicians who participate in our network have the ability to admit patients to at least one in-network hospital
• In December, we provided advance notice to Mount Sinai physicians that they would need to obtain admitting privileges to at least one in-network hospital over the next few months should Mount Sinai’s hospitals leave our network
• This letter provided these physicians instructions on how to obtain admitting privileges to another in-network hospital
• The majority of Mount Sinai’s physicians have yet to obtain admitting privileges to another in-network hospital
• We are in the process of sending a follow-up letter to these physicians notifying them they will no longer participate in our network for employer-sponsored and individual plans, including the Oxford Health Plan, effective March 22, 2024, unless they obtain admitting privileges to another in-network hospital

• In our ongoing efforts to keep members and customers informed, we are notifying impacted members whose physician has yet to obtain admitting privileges to another in-network hospital
• It’s important to note this only impacts the participation status of physicians for our employer-sponsored and individual plans, including the Oxford Health Plan

• Our top priority is ensuring the New York families we serve have access to the care they need. People enrolled in UnitedHealthcare fully insured plans who are in active treatment with a Mount Sinai physician who goes out of network are eligible for continuity of care for an additional 90 days beyond the March 22 termination date. Depending on the member’s condition and course of treatment, the continuity of care period could extend beyond the initial 90 days
• Consistent with New York regulations, people enrolled in fully insured plans sitused in New York are not required to be pre-approved for continuity of care nor do they have to fill out a form to apply for continuity of care
• It’s important to note women who are pregnant and are actively receiving services from a Mount Sinai physician who goes out of network are eligible for continuity of care. The continuity of care will be administered through the course of the pregnancy, including post-partum services

• People enrolled in ASO commercial plans are eligible for continuity of care for an additional 90 days beyond the March 22 termination date if they are in active treatment for a serious or complex condition. Depending on the member’s condition and course of treatment, the continuity of care period could extend beyond the initial 90 days

Enclosed for your information is an updated employer-broker notice regarding our current negotiations with Mount Sinai Health System. We also have updated our microsite with the latest details at www.uhc.com/sinai.

We want to thank you for your patience during this difficult negotiation. We know many people value having access to Mount Sinai’s hospitals and its physicians and are rightfully concerned by this news. Please know we remain committed to continued discussions. However, we need Mount Sinai to join us at the negotiating table and work with us to find a solution that is affordable for the people and businesses we serve. 

Download the Employer Update Here

Download the Oxford Update Here

Download the UHC Update Here

Sincerely,

Your UnitedHealthcare team