New York, NY, March 16, 2026 (GLOBE NEWSWIRE) -- As contract negotiations between Mount Sinai Health System and Anthem Blue Cross Blue Shield remain unresolved, Mount Sinai today released a new episode of its podcast The Vitals titled “When Coverage Breaks Down: The Hidden Costs of Insurance Disputes.” The episode explains why disputes between insurers and health systems occur and provides practical guidance for patients navigating sudden changes in insurance network coverage.
Mount Sinai hospitals, facilities, and physicians are currently out of network with Anthem after the insurer stepped away from finalizing an agreement that was within reach.
“Over the past several months, Mount Sinai made repeated good-faith efforts to reach a responsible agreement that would restore in-network access for our patients,” said Brent Estes, Senior Vice President and Chief Managed Care Officer of the Mount Sinai Health System. “Anthem’s refusal to finalize enforceable contract provisions designed to protect patients from excessive denials, delayed determinations, and prolonged administrative disputes remains an issue.”
The podcast episode helps patients understand how insurance negotiations affect access to care and continuity with trusted physicians.
Addressing Misleading Claims
Mount Sinai sets the record straight, addressing several public claims made by Anthem:
- Rate requests: Mount Sinai is seeking single-digit annual increases over three years, not the “50 percent higher rates” Anthem has publicly claimed.
- Below-market reimbursement: Anthem reimburses Mount Sinai up to 35 percent less than other major New York health systems for comparable services.
- Outstanding payments: Anthem currently owes Mount Sinai more than $450 million for care already delivered to its members.
- Administrative barriers: Mount Sinai is seeking enforceable timelines and operational safeguards to reduce excessive claim reviews, delayed determinations, and prolonged appeals that interfere with timely patient care.
Mount Sinai emphasized that the dispute is about fair dealing, patient protections, and sustainable care delivery, not simply reimbursement rates.
A Resource for Patients
The Vitals episode explains how insurance negotiations unfold and offers practical steps patients can take if their hospital or physician becomes out of network.
Topics include:
- Why contract disputes between insurers and health systems occur
- What patients should do if their doctor suddenly becomes out of network
- How coverage changes can affect continuity of care
- Where patients can seek assistance navigating insurance coverage
“Mount Sinai remains prepared to negotiate with Anthem to restore access for the communities we serve,” said Estes. “But negotiations require both parties to commit to enforceable terms that protect patients and support sustainable care delivery.”
Listen to the Episode
The full episode of The Vitals, “When Coverage Breaks Down: The Hidden Costs of Insurance Disputes,” is available wherever podcasts are streamed or at Mount Sinai Negotiations with Anthem | Keep Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across seven hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 10 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2025-2026.
For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Instagram, LinkedIn, X, and YouTube.
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