Cancer care provider dropped from some BlueCross plans

Empire BlueCross BlueShield has told about 1,300 cancer and blood-disorder patients that their care provider, New York Cancer & Blood Specialists, will no longer be in their insurance network effective June 1.

The insurer said the decision impacts patients in its Medicare Advantage HMO and Dual Special Needs Plan networks. A DSNP is a plan for patients who qualify for Medicare and Medicaid. 

Port Jefferson Station-based New York Cancer & Blood Specialists' status with the Medicare Advantage PPO network and any other Empire network did not change, the insurer said.

Empire BlueCross BlueShield said the decision was made as "a result of our regular network review." 

In a statement, the insurer said patients could continue to use New York Cancer & Blood Specialists until June 1. "Our customer service department will assist members who wish to continue their care for that limited time or help them find an alternate health care provider," Empire said. Members can find a list of in-network providers at empireblue.com.

New York Cancer & Blood Specialists handles about 350,000 patient visits annually at its 42 locations, including 15 on Long Island.

Dr. Jeff Vacirca, CEO at New York Cancer & Blood Specialists, said the provider was caught off guard by the decision.

"Insurers typically have a conversation with a provider before narrowing a network," Vacirca said. "If we are a higher cost because we are cutting-edge or are early adopters, let's talk about it. Call me."

Insurers and providers have increasingly taken tougher negotiating stands as profit margins thin in both sectors, experts have said. Usually those disputes, often with larger health systems, are settled. For example, last year the contract between Empire BlueCross BlueShield and Oceanside-based South Nassau Communities Hospital expired, and that led to concern that the hospital, along with doctors in the system, could have fallen out of network. But after a cooling-off period, an agreement was reached.

Vacirca said many of the patients affected live on the East End.

"For some of them, they'll have to drive an hour for care," he said.

Jeanette LaMothe of Greenport said she has been getting post-cancer care at New York Cancer & Blood Specialists' office in Riverhead.

"I'm going to have to drive a lot further," she said. "It's a small disaster. I have other medical issues as well, so this matters for my continuity of care." 

Breast cancer patient Susan Ryan of Stony Brook said she had a recurrence about a year ago and is undergoing care at New York Cancer & Blood Specialists.

"I'm shocked, and I haven't been able to get an answer about why this is happening," she said. "I can say that if it weren't for [New York Cancer & Blood Specialists], I don't know that I'd be here."

Empire said it properly followed guidelines before making its decision to drop the provider.

"This update to our network meets all standards set by the Centers of Medicare & Medicaid Services regarding the availability of providers for our members," it said. "Empire consumers continue to have a broad network of care providers from which to choose."