A contract dispute between Healthfirst and Catholic Health is raising concerns among Long Island residents and officials who fear thousands of patients could soon lose access to trusted doctors, hospitals and specialists.
The disagreement threatens coverage for more than 300,000 Long Islanders enrolled in Healthfirst plans through Medicaid, Child Health Plus, the Essential Plan and Affordable Care Act marketplace programs. Catholic Health, which operates six hospitals and numerous outpatient facilities across Nassau and Suffolk counties, would become out-of-network if the two sides don’t settle.
Assemblyman Joseph DeStefano warned the dispute could create major hardships for working families, seniors and patients already struggling with rising living costs.
“This is not just another corporate disagreement,” DeStefano said. “Families should never have to fear losing access to their doctors because billion-dollar institutions failed to reach an agreement behind closed doors.”
DeStefano called for New York State to require mandatory binding arbitration before major insurers and hospital systems can terminate agreements affecting large numbers of patients. He urged Albany to strengthen continuity-of-care protections and increase transparency during negotiations. He’s also pushed Gov. Hochul to more aggressively weed out corruption and fraud in the health care system.
According to Catholic Health, negotiations with Healthfirst broke down after the insurer allegedly sought reimbursement reductions the health system said would impact patient care. Healthfirst said it remains focused on maintaining affordable access for its more than 2 million members statewide.
Beginning May 15, Catholic Health hospitals and physicians are expected to become out-of-network for several Healthfirst plans unless an agreement is reached. Patients currently receiving active treatment may qualify for temporary continuity-of-care protections.
Health care analysts say disputes between insurers and hospital systems are becoming increasingly common nationwide as rising labor costs, Medicaid reimbursement pressures and disputes over payment structures strain providers and insurers alike.
DeStefano said Albany must take action before more Long Islanders are caught in the middle.
“The people being hurt are not corporate executives or insurance lawyers,” he said. “They are cancer patients, pregnant mothers, senior citizens, children with chronic illnesses and working families trying to make ends meet.”