New York payer drops CCS Oncology

Buffalo, N.Y.-based Independent Health will drop about 560 members receiving cancer treatment from Williamsville, N.Y.-based CCS Oncology after negotiations to initiate value-based reimbursements went unresolved, The Buffalo News reported.

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Next year, affected policyholders purchasing coverage through an employer, an individual plan or Medicare Advantage will have to find new oncologists or face increased costs. The decision arrived 18 months after negotiations between the insurer and provider commenced. The parties reached an impasse after Independent Health urged for reimbursement based on outcomes and not fee-for-service.

Independent Health notified 22 oncologists they would be out-of-network beginning Jan. 1. Patients, employers and insurance brokers have also been informed. The change will not affect the 51 physicians in CCS Oncology’s parent organization, Williamsville, N.Y.-based CCS Healthcare.

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