SYRACUSE, N.Y. — Excellus Blue Cross Blue Shield customers in are once again caught in a contract dispute between the insurance company and a major healthcare provider.

Over the weekend, FamilyCare Medical Group – which states it is the largest practice of primary care clinicians in Central New York – sent a letter to thirty thousand patients, warning them that their doctors may be out of the Excellus network by January 1. CEO Dr. Mitchell Brodey said that it ultimately comes down to quality care; he said that FamilyCare is looking to continue expanding services in a region that is sorely in need of more medical options, and Excellus is the only insurance company they work with that is not pitching in to help.

“There’s money that we think that we are entitled to and they do not think that we are entitled to,” Dr. Brodey said, “Excellus is not pulling its weight. They’re getting the benefit without putting anything into it.”

According to Dr. Brodey, this is not about raising rates for patients; in fact, he argues the opposite. He said that given major shortage of primary care doctors, it’s critical that FamilyCare is able to remain independent while hiring new nurses, doctors and specialists. He said that the issue with Excellus is that the insurance company is repeatedly denying patient claims and failing to provide patient data that would help them with the effort to expand quality care.

He said that if FamilyCare ends up out of network for Excellus customers in 2025, it will be on the insurance company, insisting this is the only course of action to ensure that doctors are the ones directing proper medical decisions for patients.

“Quality of care is not a negotiation,” Dr. Brodey said, “for the good of the community this is something that we have to do.”

Dr. Brodey said that the letter went out to give patients time to explore other options and put pressure on Excellus. The insurance company’s Chief Medical Officer Dr. Lisa Harris said that negotiations are ongoing, disappointed that Family Care is choosing to – in Excellus’ opinion – cause panic when the deadline is still five months away.

According to Dr. Harris, the idea that Excellus is not supporting certain kinds of clinical care at FamilyCare is news to them, finding out about this specific issue through the media despite confirming negotiations have been going on for over a year.

“We encourage FamilyCare Medical Group to bring those concerns directly to our attention so we could have some conversation about how to address those,” Dr. Harris said.

This latest dispute comes after Excellus customers entered 2024 without WellNow Urgent Care as an in network option. The Jan. 1 deadline came and went with the two still at an impasse, with WellNow arguing that Excellus was providing reimbursements well below market rate, while Excellus believed WellNow was being unreasonable.

“The WellNow provider contract was really an anomaly, that was just an unusual situation and its important for our members to know that 98% of our local providers are in our network,” Dr. Harris said.

Still, Excellus customers are now at risk of losing access to FamilyCare as well. Dr. Harris said that negotiations will continue, with both parties hoping to find a way to a deal. She said that in the meantime, Excellus customers are encouraged to call the customer service line on the back of their insurance cards with any questions.

As for Dr. Brodey, he said that patients should be calling Excellus to push them towards providing FamilyCare with additional resources. He said that they will never turn anyone away if they leave the Excellus network, stating they will look for ways to assist with out of network co pays if there’s no agreement by the new year.