Oncology group sues payer over coverage lapse affecting 500 patients

CCS Oncology filed suit against Independent Health to prevent the insurer from dropping CCS from its network, affecting more than 500 cancer patients and threatening the financial viability of the cancer center, reports ArtVoice.

Independent Health notified 22 oncologists at CCS "that it will not renew its contract with them," effective Jan. 1. The 51 non-oncology physicians at CCS will remain in the health plan's network. Independent Health attributed the network change to cost analysis data that showed treatment for lung and breast cancer cost up to 50 percent more at CCS compared to its competitors.

CCS disputes the cost analysis, according to the article. CCS CEO and medical director Won Sam Yi, MD, said the change will affect 30 percent to 40 percent of CCS' cancer patients and harm the group's ability to function.

CCS filed suit against the insurer to prevent it from dropping CCS from its network without letting CCS verify Independent Health's cost analysis. Thus far, the insurer has refused to let CCS look at the data.

The New York Supreme Court will hear arguments this month.

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