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NYC medical providers negotiate insurance deals

Nov 23rd 2013 at 3:50 AM

With deadlines looming, medical providers and insurers in New York are negotiating deals that may determine which doctors you can see if you buy a health plan through the state's new insurance marketplace.

One of the world's most respected cancer hospitals, Memorial Sloan-Kettering Cancer Center, announced Friday that it had signed agreements to join the networks of three plans being sold through the exchange: Health Republic Insurance, Oscar Insurance and Oxford Health Plans. Oxford will only be available to small businesses.

Two are new companies. Oscar is a startup, founded by three young Harvard Business School graduates. Health Republic is a nonprofit, member-owned cooperative.

As recently as Thursday, Sloan-Kettering wasn't included on any of the 19 health plans sold through the insurance exchange. It remains among a number of prestigious research hospitals in the city, and elsewhere, that only take a small number of the new plans.

The hospital said in a statement that it was committed to remaining accessible and was in active negotiations with additional insurers, but was taking a "thoughtful approach" to the talks.

"We are also mindful of our fiscal responsibilities and fiscal viability — that includes our ability to be adequately reimbursed for the expenses incurred in the delivery of care," it said.

While the insurance marketplace shakes out, consumers may have to select a new health plan without knowing if their doctor will be in a particular insurance network.

At least 100,000 New Yorkers whose old policies had been canceled because of the national reforms need to pick a new health plan by next month if they don't want their coverage disrupted.

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