Important Information for Patients with CDPHP Health Insurance

A: At this time, nothing changes. Patients should continue to schedule appointments and receive care from St. Peter’s Health Partners as usual. To ensure our patients continue receiving the care they need, St. Peter’s Health Partners has made the decision to extend in-network access for all patients covered by a CDPHP health plan through February 28, 2026, unless a new agreement with CDPHP is reached sooner.

A: St. Peter’s Health Partners is working on a new agreement with CDPHP to stay in their network and continue providing care to our patients covered by CDPHP commercial, Medicare Advantage, Medicaid, and Essential Plan (administered by NY State of Health) health plans. Our current contract expires January 1, 2026. St. Peter’s Health Partners has continued to meet its obligations under the current agreement and has sought a fair resolution to ongoing contract issues with CDPHP. Unfortunately, the ongoing contract issues with CDPHP remain unresolved, making it unlikely that St. Peter’s Health Partners will renew its contract with CDPHP.

A: As a trusted local health care provider, we work tirelessly to care for our community while managing costs and improving efficiency. CDPHP must provide fair and timely reimbursement to help us maintain access to the doctors, nurses, and services patients rely on. Without a fair agreement, it becomes difficult to sustain the quality of care our patients deserve.

A: A: Our current agreements will expire effective January 1, 2026.

To ensure our patients continue receiving the care they need, St. Peter’s Health Partners has made the decision to extend in-network access for all patients covered by a CDPHP health plan through February 28, 2026, unless a new agreement with CDPHP is reached sooner.

A: CDPHP commercial, Medicaid, and Essential Plan (administered by NY State of Health) health plans. 

A: All St. Peter’s Health Partners hospitals, facilities, and employed providers are affected by these negotiations, including:

• Medical Group Providers:
  • Peter’s Health Partners Medical Associates
  • Samaritan Hospital Clinics and Providers
  • Peter’s Hospital Clinics and Providers
  • Trinity Health Anesthesia Group of New York
• Hospitals, Facilities & Services:
  • Peter’s Hospital
  • Samaritan Hospital
  • Sunnyview Rehabilitation Hospital
  • Eddy Memorial Geriatric Center
  • Eddy Heritage House Nursing & Rehabilitation
  • Eddy Village Green at Beverwyck
  • Eddy Village Green at Cohoes
  • Our Lady of Mercy Life Center
  • Schuyler Ridge Residential Healthcare
  • Peter’s Nursing & Rehabilitation Center
  • Eddy Visiting Nurse & Rehabilitation Association
  • Empire Home Infusion Services including Northeast Home Medical Equipment
  • The Community Hospice
• Additionally, St. Joseph’s Health locations in Onondaga, Madison, Oneida, Jefferson, and Cayuga counties are also impacted including:
  • St. Joseph’s Health Hospital, Clinics and Providers
  • St. Joseph's Physicians

A: While negotiations continue, here’s how you can help protect your access to in-network care:

• Never delay care. You will always have in-network access to our Emergency Departments. Regardless of our network status with CDPHP, you should always visit the closest emergency department if you experience a medical emergency.
• Call the number on the back of your insurance card and urge CDPHP to keep your in-network access to your doctors.
• If you receive coverage through your employer, speak with your HR team and explain how losing access to our systems facilities and providers would affect you.
• If you are covered by a Medicaid or the Essential Plan, visit https://www.health.ny.gov/health_care/medicaid/members/. You can consider alternative health care coverage that protects your ability to affordably access our system regardless of our status with CDPHP. Additionally, patients enrolled in a Medicaid plan can call the state help line at 800-541-2831.
• If you have a Medicare Advantage plan through CDPHP, the Annual Enrollment (AEP) ended on December 7. You may have options to pursue guaranteed in-network plans during Open Enrollment which runs from January 1- March 31, 2026. Find other insurance carriers at https://www.sphp.com/for-patients/billing-information/accepted-insurance.

A: If you are admitted before February 28, 2026, you will continue to be covered at in-network rates for the duration of your inpatient stay.

A: If possible, call your provider’s office to reschedule the appointment before the extended in-network coverage date of February 28, 2026. If you keep your appointment after this date and St. Peter’s Health Partners is out of network, you may face higher out-of-pocket costs.

A: You will always have in-network access to emergency care at our Emergency Departments, regardless of our contract status with CDPHP. Emergency treatment will be covered at in-network rates until you are stable.

A: For the latest information, visit sphp.com/CDPHP or call our patient hotline at (518) 219-0660.