EmblemHealth issued New York City-based Mount Sinai Health System’s independent practice association a cease-and-desist letter regarding its decision to stop accepting new patients from some of the insurer’s government-backed plans.
The insurer sent Vincent Tammaro, Mount Sinai’s executive vice president and CFO, the letter Aug. 19. Politico first reported that an archived version of Mount Sinai’s website said the health system stopped accepting some new patients with government-backed health plans — including EmblemHealth’s Medicaid plan, Essential Plan, Health and Recovery Plan and Child Health Plus offering — Aug. 1. While the notices have since been removed from the website, Mount Sinai confirmed the new patient policy to Becker’s but said some exceptions apply for new transplant, obstetrics and pediatric patients.
According to an internal memo reviewed by Politico, Mount Sinai is defining new patients as those who had not seen a Mount Sinai provider since July 31, 2025.
The cease-and-desist letter, obtained by Becker’s, accused Mount Sinai of violating the organizations’ existing agreement. An EmblemHealth source previously told Becker’s that the insurer’s contract with Mount Sinai is valid until Jan. 1, and the organizations are currently negotiating the upcoming contract.
The cease-and-desist letter said the current agreement requires Mount Sinai to treat EmblemHealth members, regardless of payment source, in an aligned manner. Violations allow for immediate termination of the provider’s network participation. The letter also said EmblemHealth had not received written notice from Mount Sinai expressing a decision to withdraw from a specific benefit plan, in line with the contractual process.
The insurer called for Mount Sinai to stop refusing new patients from EmblemHealth based on their plan, restore care access for members, have personnel implement the directive and give the insurer written confirmation Aug. 21 by the end of the business day that the refusal has been rescinded.
EmblemHealth said it plans to take all relevant action, including seeking legal relief, if Mount Sinai does not comply.
Becker’s contacted Mount Sinai and will update this story if more information becomes available.
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