Updated January 27, 2023
Important information regarding UnitedHealthcare Community Plan’s relationship with Mount Sinai
We are disappointed that Mount Sinai chose to end our Medicaid contract. We made numerous compromises and believe we met all of the health system's demands as part of a good-faith negotiation to continue our relationship.
Despite this, Mount Sinai still chose to leave our UnitedHealthcare Community Plan network.
That means the health system’s hospitals and facilities are now out of network for UnitedHealthcare Community Plan, including our Dual Special Needs Plan (DSNP), as of Jan. 1, 2023.
Mount Sinai’s physicians will remain in-network for people enrolled in our UnitedHealthcare Community Plan through March 31, 2023. Effective April 1, 2023, Sinai’s physicians will no longer participate in our Medicaid network, including DSNP.
Some health plans will have network access to Mount Sinai's facilities through Feb. 28
As part of our effort to avoid disruption to care for the people we serve, we have agreed to apply a cooling-off period for Mount Sinai’s facilities for our New York Children’s Health Insurance Program (CHIP), Community Wellness4Me, Essential Plan and Medicaid plans.
This will ensure the people enrolled in these plans have continued in-network access to Mount Sinai’s facilities through Feb. 28, 2023, while we continue to negotiate in an effort to renew our relationship as well as to assist our members in finding new providers that best meet their health care needs, if necessary.
Cooling off does not apply to DSNP. UnitedHealthcare members enrolled in DSNP no longer have in-network access to Mount Sinai as of Jan. 1, 2023.
We know the relationship you and your family have with your doctor is not only important; it’s personal
Please know our top priority is to renew our relationship with Mount Sinai. We are committed to meeting with Mount Sinai as often as it takes to reach a new agreement. However, we need Mount Sinai to join us at the negotiating table so the thousands of New Yorkers we collectively serve have continued access to the facilities and physicians they know and trust for their health care needs
This negotiation does not impact people enrolled in our employer-sponsored, individual or Medicare Advantage plans. They continue to remain in-network with Mount Sinai.
FAQs
Mount Sinai’s hospitals and facilities no longer participate in our UnitedHealthcare Community Plan network, including our Dual Special Needs Plan (DSNP), as of Jan. 1. 2023.
However, as part of our effort to avoid disruption to care for the people we serve, we have agreed to apply a cooling-off period for Mount Sinai’s facilities for our New York Children’s Health Insurance Program (CHIP), Community Wellness4Me, Essential Plan and Medicaid plans.
This will ensure the people enrolled in these plans have continued in-network access to Mount Sinai’s facilities and physicians through Feb. 28, 2023, while we continue our efforts to keep Mount Sinai in our network as well as to assist our members in finding new providers that best meet their health care needs, if necessary.
Cooling off does not apply to DSNP. UnitedHealthcare members enrolled in our DSNP no longer have in-network access to Mount Sinai, as of Jan. 1, 2023.
Mount Sinai’s physicians continue to remain in our Medicaid network through March 31, 2023. Beginning April 1, 2023, Sinai physicians will no longer participate in our Medicaid network, including DSNP.
Mount Sinai’s physicians will remain in-network for people enrolled in our UnitedHealthcare Community Plan through March 31, 2023. Effective April 1, 2023, Sinai’s physicians will no longer participate in our Medicaid network, including DSNP.
This negotiation impacts the following UnitedHealthcare Community Plans:
- New York Children’s Health Insurance Program (CHIP)
- Community Wellness4Me
- Essential Plan (EPP)
- Medicaid
- DSNP
UnitedHealthcare employer-sponsored, individual and Medicare Advantage plans are not impacted by this negotiation and continue to remain in-network with Mount Sinai.
Mount Sinai issued a notice to end our Medicaid contract, including our Dual Special Needs Plan (DSNP), effective Jan. 1, 2023. Our goal has always been to keep Mount Sinai in our Community Plan network. That’s why we have delivered multiple proposals to the health system, including countering ourselves, as we worked to compromise as part of good-faith negotiation.
We believe our latest proposal provided Mount Sinai everything it was seeking as part of our negotiation. Despite this, Mount Sinai still chose to leave our UnitedHealthcare Community Plan network. We continue to urge the health system to reconsider its decision and to work with us on a new agreement on behalf of the thousands of New Yorkers we collectively serve.
Our top priority is to renew our relationship with Mount Sinai. However, we want you to know you continue to have access to a large network of hospitals, physicians and specialists that are readily able to provide high-quality care that meets your health care needs despite Mount Sinai’s decision to leave our network.
Some of the hospitals that continue to participate in our Community Plan network include but are not limited to:
- Flushing Hospital Medical Center
- Maimonides Community Hospital
- Nassau University Medical Center (NUMC)
- NY Presbyterian Columbia
- NY Presbyterian Cornell
- NY Presbyterian Downtown
- NYC HHC Bellevue
- NYC HHC Elmhurst
- NYC HHC Metropolitan
Should you or someone in your family need assistance finding a new physician or health care facility that meets your needs, please call member services at the phone number on your health plan ID card. You may also go to UHCCommunityPlan.com to find physicians or facilities in your area that participate in our network.
If you are in the middle of treatment at a Mount Sinai hospital, facility or with a Mount Sinai physician, you may qualify for continuity of care after the health system goes out of network. Continuity of care provides continued in-network benefits for a specified period of time after a hospital or physician leaves our network. A few examples of patients who may qualify include:
- Women who are pregnant and undergoing a course of treatment for the pregnancy from the provider or facility.
- Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.
If you or someone in your family has questions about continuity of care, please call member services. The number can also be found on your member ID card.
You should always go to the nearest hospital in the event of an emergency. Your services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.