Health Insurer Drops Cancer Care Provider From Network

Blue Cross Blue Shield headquarters in downtown Rochester, New York

Local cancer victims requiring radiation treatment who rely on Empire Blue Cross/Blue Shield to pay may lose coverage from their health insurance provider depending on the treatment center they use. Earlier this month, Empire notified New York Cancer & Blood Specialists that reimbursements would end June 1. New York Cancer & Blood Specialists handles about 350,000 patient visits annually at its 42 locations, including 15 on Long Island.

A few days later, Empire cut Integrated Medical Professionals of Farmingdale, a urology and radiation oncology practice with 52 locations on Long Island.

There are about 1300 Long Islanders who will be affected. Dr. Deepak Kapoor, the group’s chairman and CEO, reportedly said Integrated plans to hold on to its patients.

“We have decades of doctor-patient relationships impacted,” Kapoor said. “Our hope is we can talk to the insurer and work it out like adults. We are exploring every recourse at our disposal to ensure continuity of care for our patients.”

Calls to New York Cancer & Blood Specialists were not returned by press time.

Empire said the decision was made as “a result of our regular network review.” The insurer said the decision affects patients in its Medicare Advantage HMO and Dual Special Needs Plan networks. A DSNP is a plan for patients who qualify for Medicare and Medicaid.

Port Jefferson Station-based New York Cancer & Blood Specialists’ status with the Medicare Advantage PPO network and any other Empire network did not change, the insurer said.

For East Enders, patients already stymied by a shortage of facilities will have to find another place for treatment up-island, and bear the costs of gas and auto maintenance that comes with the change. A spokeswoman for Integrated Medical Professionals said its Centereach and East Patchogue
offices are already packed with patients, including “a fair amount” from the East End.

Last year, Empire BlueCross BlueShield dropped payments to Oceanside-based South Nassau Communities Hospital after its contract expired, but eventually new terms were reached.

“This update to our network meets all standards regarding the availability of providers for our members. Empire consumers continue to have a broad network of care providers from which to choose,” the company said in a press release.

Stony Brook Southampton Hospital and the Southampton Hospital Association will host a ribbon-cutting ceremony to celebrate opening of the Phillips Family Cancer Center on Thursday, April 25. A fully integrated site of the Stony Brook University Cancer Center with access to Stony Brook researchers and clinicians, the facility should be up to speed by August, when the Oncology Center opens.

“The Phillips Family Cancer Center is changing cancer care on the East End of Long Island,” said Barbara Joe Howard, a spokeswoman for the hospital.

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