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Edited by: TJVNews.com
By 2025, thousands of cancer patients at Memorial Sloan Kettering Cancer Center (MSK) could face the devastating reality of losing access to life-saving treatments due to an unresolved contract dispute with insurance giant Anthem Blue Cross Blue Shield. According to a report in The New York Post, MSK leadership expressed grave concerns on Wednesday, signaling little confidence that an agreement would be reached before the current contract expires on January 1, 2025. The potential fallout would force patients out of network, presenting a choice between discontinuing critical treatments or bearing insurmountable medical costs.
BREAKING: Anthem Blue Cross Blue Shield calls off decision to cap anesthesia for surgical patients pic.twitter.com/LrKsY5DmE0
— unusual_whales (@unusual_whales) December 5, 2024
Carrie Regan, a 41-year-old teacher and mother of four from Hudson Valley, who battled ovarian cancer diagnosed in August 2023, shared her distress with The New York Post. Regan, now cancer-free but requiring monthly checkups, described the looming uncertainty as “crippling.” She said, “I feel like once you have cancer… you live scan to scan.” The lack of clarity from Anthem has exacerbated her anxiety. “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,” she added.
The crux of the dispute lies in Anthem’s reimbursement rates to MSK. As reported by The New York Post, MSK’s Chief Financial Officer, Mike Harrington, accused Anthem of prioritizing profits over patient care. This impasse could affect approximately 22,000 active patients, while the hospital treated a total of 71,233 individuals in 2023. Harrington stated, “Anthem continues to show it puts profit ahead of patient care.”
Following Anthem Blue Cross Blue Shield’s proposal—and subsequent reversal—to impose a time limit on anesthesia services, Congress is considering a bill that would ban insurance companies from setting such limits on anesthesia care. More: https://t.co/X8AxfRrhI5.
— S.C.A.N.A. (@SCcrnas) December 20, 2024
New York law offers a temporary reprieve, mandating in-network care for current MSK patients insured by Anthem until March 1, 2025. However, The New York Post report emphasized that the looming January 1 deadline remains critical for reaching a resolution. Harrington called attention to MSK’s commitment to negotiating in good faith but accused Anthem of showing little interest in a fair resolution.
The dispute comes as health insurance practices face heightened public scrutiny. According to the information provided in The New York Post report, recent events, including the murder of UnitedHealthcare CEO Brian Thompson and Anthem’s controversial proposal to limit anesthesia coverage for surgical procedures, have sparked widespread outrage. Anthem swiftly reversed its anesthesia policy following intense backlash but continues to face criticism for its handling of patient care issues.
Anthem Blue Cross Blue Shield had planned to limit coverage for anesthesia in surgeries that exceed a specific time limit, affecting policyholders in Connecticut, New York, and Missouri. The policy would have gone into effect in February 2025. #HealthTips pic.twitter.com/1THqtkQWVF
— InforMed (@InforMedLab) December 20, 2024
Harrington pointed out to The New York Post that Anthem has underpaid MSK for years, reimbursing the hospital at rates 34% lower than other National Cancer Institute-Designated Cancer Centers in Manhattan. MSK is now proposing a rate increase to ensure sustainable operations. Even with the adjustment, the hospital would still receive at least 10% less reimbursement compared to similar institutions. Harrington argued, “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.”
This dispute shines a proverbial spotlight on broader systemic issues in healthcare, where insurance giants are frequently criticized for profit-driven policies, The New York Post report said. The potential disruption to MSK’s operations could set a precedent for other institutions grappling with similar challenges. For thousands of cancer patients like Regan, the stakes couldn’t be higher.
The clock is ticking for Memorial Sloan Kettering and Anthem Blue Cross Blue Shield to resolve their differences. As patients face the harrowing prospect of disrupted care, the importance of equitable healthcare policies has never been more apparent.
