Tens of thousands of New Yorkers insured through Aetna could lose coverage for New York-Presbyterian’s 10 hospitals, two large physician networks, and its array of specialty clinics in the coming months — with some types of care potentially going out of network on April 1.
The insurance giant and hospital system are trying to negotiate a contract by the end of the month and have yet to reach an agreement. Both sides are blaming the other for the current situation.
“At this time in our discussions, we believe we are far apart on terms because New York-Presbyterian is demanding significant increases in reimbursement rates that are unsustainable and will materially raise costs for our health plan sponsors and our members,” Aetna spokesperson Alex Kepnes said in a statement this week. “We remain committed to negotiating in good faith for a fair contract.”
New York-Presbyterian spokesperson Angela Karafazli said in a statement that the hospital network is committed to negotiating “around the clock” to reach a deal by the end of March, but added that “so far, Aetna has presented an unreasonable offer that would jeopardize our ability to provide the best care.”
Neither party would say exactly how many patients would be affected if they fail to renew the contract, though Karafazli said it would be “many tens of thousands.”
New York-Presbyterian is known for leading academic medical centers like Weill Cornell Medical Center on the Upper East Side and Columbia University Irving Medical Center in Washington Heights. It also runs neighborhood hospitals like Brooklyn Methodist and specialized facilities like the Morgan Stanley Children’s Hospital and the Westchester Behavioral Health Center.
If the talks break down, New York-Presbyterian hospitals will go out of network for Aetna members on April 1, but patients will still be covered for emergency care. Outpatient care at medical practices in the ColumbiaDoctors or Weill Cornell Medicine networks would go out…
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