Mount Sinai gets cease-and-desist from EmblemHealth over new-patient policy

The letter, sent Aug. 19 to Mount Sinai EVP and CFO Vincent Tammaro, follows an archived website notice stating the system halted new patient admissions Aug. 1 for EmblemHealth's Medicaid plan, Essential Plan, Health and Recovery Plan, and Child Health Plus. Mount Sinai confirmed the policy to Becker's, noting exceptions for new transplant, obstetrics, and pediatric patients. Per an internal memo, "new patients" are those without a Mount Sinai visit since July 31, 2025.

EmblemHealth's letter alleges the policy violates the existing agreement, which requires Mount Sinai to treat EmblemHealth members regardless of payment source. It warns violations allow immediate termination of network participation and notes Mount Sinai did not provide contractual written notice of withdrawal. The insurer demanded Mount Sinai rescind the refusal and provide written confirmation by end of business Aug. 21, threatening legal action if noncompliant. EmblemHealth's contract with Mount Sinai runs through Jan. 1, with negotiations ongoing, a source previously told Becker's.