Mount Sinai is warning that as many as 80,000 patients insured through Cigna could lose in-network access to its hospitals and doctors beginning February 1 if the health system and the insurer cannot agree on a new contract before their current deal expires at the end of Sunday, January 31. The warning covers Cigna commercial insurance plans, including coverage that patients get through their employer.
According to Crain's New York, Mount Sinai said the 80,000-patient figure reflects how many people could be affected if the two sides fail to reach terms. The health system, whose flagship hospital sits on the Upper East Side, laid out the stakes in a public FAQ page, noting that Mount Sinai and Cigna are working to establish a new contract before the current agreement lapses. If no deal is reached, the hospital system says, patients' coverage and out-of-pocket costs could change depending on their specific Cigna plan and benefits.
Mount Sinai has stressed that emergency care is protected regardless of how the negotiations shake out. All insurance companies are required to process emergency care claims as if a patient were still in network, the health system says, meaning a trip to the ER would not suddenly come with out-of-network costs even if the broader contract collapses.
A Familiar Standoff for Mount Sinai
This is not the first time Mount Sinai has squared off publicly with a major insurer over contract terms. In 2024, UnitedHealthcare said roughly 80,000 Mount Sinai patients were affected when the two sides hit an impasse, with Mount Sinai's hospitals going out of network for people insured through UnitedHealthcare or Oxford and many affiliated doctors slated to follow, according to The New York Times.
A separate dispute with Anthem Blue Cross Blue Shield also spilled into public view. Negotiations between Mount Sinai and Anthem collapsed at one point, pulling the system's providers and services out of Anthem's network, per MedCity News, which also reported that Mount Sinai operates seven hospital campuses and employs more than 9,000 physicians. CBS New York later reported that about 9,000 Mount Sinai physicians became out of network for roughly 200,000 Anthem patients after the sides initially failed to reach an agreement, though the parties ultimately agreed to temporarily extend in-network access for Mount Sinai hospitals and facilities through March 1 only.
Money was at the center of that fight. Mount Sinai said Anthem owed it more than $450 million for care already provided to its members, while Anthem alleged that Mount Sinai executives were seeking price increases of more than 50% over three years — a claim Mount Sinai disputed, the station reported.
What Patients Can Expect If Coverage Lapses
New York offers some protections for patients caught in the middle of these fights. The New York Attorney General's office says patients can generally continue seeing a provider who leaves their network at the same cost for 90 days, with postpartum care allowed to continue until that care is complete. Separately, the New York Department of Financial Services says that if a disputed hospital claim is paid more than 12 months after a prior contract expired, the payment must be at least 25% greater than the prior contracted rate, adjusted based on the medical consumer price index.
Whether those protections will come into play here remains to be seen, since Mount Sinai's FAQ does not say what happens next if the January 31 deadline passes without a deal.
Part of a Broader Pattern Nationally
Hospital-insurer standoffs like this one are increasingly common, though they do not always end in a network split. From June 2021 through May 2025, about one in five hospitals had at least one public dispute with an insurance company, and about 8% went out of network with that insurer for at least some period, according to NBC News. The outlet cited preliminary research estimating that roughly 500 to 600 public disputes between hospitals and insurers occur each year, and noted that total hospital expenses grew 5.1% in 2024, outpacing the 2.9% overall inflation rate that year.
A Brown University analysis found that public threats to end a hospital-insurer contract occurred in about 8% of cases studied between August 2021 and July 2025, and that 28% of those public brinkmanship episodes ultimately resulted in an actual network exit, per Fierce Healthcare. The same analysis found that threats to pull the plug were more common when a national payer was involved and when hospitals had already secured higher rates under their prior contract.
Other recent cases show that negotiations can continue past a deadline. UnitedHealthcare and Memorial Sloan Kettering Cancer Center missed a June 30 deadline but reached a deal just one day later, briefly leaving patients in limbo.
For now, Mount Sinai and Cigna have roughly three months before the current contract runs out, and no agreement has been announced.
