Despite reaching agreement on rates of payment and finding common ground on most major issues, Mount Sinai sought additional changes to how employer-sponsored health coverage operates — including removing contractual safeguards that protect patients and employers from billing errors and unnecessary costs. No other New York health system has made these demands. If accepted, these proposals would have dramatically accelerated insurance premiums, out-of-pocket costs, and employer healthcare expenses.
As a result, effective midnight March 3, 2026, Mount Sinai hospitals and affiliated physicians are now out of network. Despite seven months of good faith negotiations, Mount Sinai declined our offers to remain in network under terms consistent with the rest of the New York market.
We remain open to continuing discussions and hope to return Mount Sinai to our network.
Supporting your clients and their employees
Our priority is minimizing disruption and protecting affordability for the employer groups and members you serve. Please share the following key information with your clients:
- Broad network access: Our network includes every other major hospital system in New York, providing affordable in-network alternatives.
- Continuity of Care: Members in active treatment at Mount Sinai may qualify for Continuity of Care protections.
- Emergency care: Emergency services are covered at in-network cost shares, regardless of facility.
- Physician participation: Some physicians affiliated with Mount Sinai have contracted directly with Anthem.
Why this happened
We reached agreement on rates of payment and all other major contract terms — and had a contract ready to sign. At the last minute, Mount Sinai refused to move forward unless we agreed to eliminate basic consumer protections that help ensure care is appropriate and patients are not overcharged.
We cannot agree to changes that would drastically increase costs for New Yorkers, employers, and the members you serve. Accepting those demands would have driven up premiums and out-of-pocket costs across the market.
We remain willing to reach a responsible agreement and will continue working to return Mount Sinai to our network. In the meantime, our focus is helping members access the care they need during this transition.
Please visit anthem.com/mountsinai for the latest updates and if you or your clients have questions, please contact your Anthem representative.
Thank you for your continued partnership.