Roswell Park and Independent Health clash over Medicare Advantage plans, affecting coverage for 2026.

BUFFALO, N.Y. — With open enrollment for Medicare for senior citizens starting Oct. 15, there is now a major disagreement between Roswell Park Comprehensive Cancer Center and Independent Health on future coverage plans.  

This involves patients in the insurance carrier’s Individual Medicare Advantage Plan.

The notice has appeared on Roswell Park Cancer Center’s website advising Medicare patients about the Independent Health issue. 

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Those enrolled currently in the Independent Health Individual Medicare Advantage Plan will not be able to continue with Roswell Park “in network,” as they say, as of January with Roswell officials concerned about what they feel is the insurance carrier’s increased cost shifting to patients. 

Roswell Park Comprehensive Cancer Center chief medical officer Dr. Julia Faller says: “We want to ensure that people have access to that care and Independent Health did not allow us the opportunity to do that. There are now currently barriers in place that prevent our patients from accessing care at Roswell Park.”

It is not clear how many patients are affected by this situation. 

An Independent Health spokesman turned down an interview request releasing only a statement:

“Significant challenges are impacting Medicare Advantage plans across the country, including Independent Health, which are causing all of us to make changes to our plan offerings1,2. Despite these challenges, Independent Health is committed to offering a choice of Medicare Advantage plans with comprehensive coverage, benefits, and access to providers.

“We had been working with Roswell Park Comprehensive Cancer Center on a new agreement for Roswell Park and its community network practices to continue as participating providers in our individual Medicare Advantage plans for 2026. Unfortunately, despite extensive negotiations, Roswell Park chose not to participate in our individual Medicare Advantage plans starting January 1, 2026.

“While Roswell Park will not participate with our 2026 individual Medicare plans, it will remain participating with our group Medicare plans as well as Commercial, State and Self-funded lines of business.

“Our individual Medicare Advantage members will continue to have access to a wide network of oncology providers, including Buffalo Medical Group, Catholic Health, Great Lakes Cancer Care Collaborative (this covers ECMC, Kaleida/GPPC, UBMD, WNY Urology, and Windsong), and Wilmot Cancer Institute (at Strong Memorial Hospital).

“In keeping with our nationally recognized customer service, Independent Health is providing detailed information and assistance to support all of our Medicare members during this annual enrollment period.”

Roswell Park’s Dr. Faller has a very different opinion.

“On this particular plan we were not at the negotiation table. I would not describe it as a negotiation. It was very much presented as this is the product, this is what we’re going to be offering. And it wasn’t something that we could see right away that it was going to shift the costs to our patients and that would therefore limit the access to Roswell Park,” Dr. Faller said.

There may also be some changes for Roswell park patients who are clients of Highmark Blue Cross Blue Shield.

Their spokesman also declined an interview and sent this statement: “While facing significant industry challenges and changes to the Medicare program, Highmark, like many insurers, is making adjustments to our Medicare Advantage plan options to maintain choice and viability for our members.

One of these adjustments is introducing new Medicare Advantage plan options with a streamlined coverage network that will not include certain providers, including Roswell Park. These plans provide a lower-premium choice alongside Highmark’s broader network options.

Highmark values our partnership with Roswell Park. Unlike some other health insurers who have completely removed Roswell Park from their networks, Highmark made the decision to maintain Medicare Advantage plan options with access to Roswell Park.

Roswell Park will participate in Highmark’s 2026 individual Medicare Advantage Senior Blue HMO plans, Forever Blue PPO, and Freedom Blue PPO plans. It will not be participating in Highmark’s 2026 Community Blue individual Medicare HMO plans. Roswell Park will continue to participate in all other plans Highmark offers to Medicare Group Retirees, large and small businesses and individuals.

Highmark is notifying members about these changes and encouraging them to use the Annual Enrollment Period (AEP) from Oct. 15-Dec. 7 to review all their available options to ensure they have the best plan that fits their needs. Highmark is committed to being fully transparent with members and to helping ensure they actively enroll in a plan that works best for them.

Unfortunately, increased health care costs, driven by trends such as expensive new drugs and increased medical utilization, have outpaced the rate of federal reimbursement over the past three years. On top of this, a federal policy change known as the “Wage Index,” mandated substantially higher hospital payments for upstate New York hospitals, further widening the gap between health care costs and the revenue provided to health plans to provide this coverage. These factors drove a $106 million loss across Highmark’s New York Medicare Advantage membership in 2024.

As a not-for-profit health plan, Highmark is working to ensure the long-term financial stability of the Medicare Advantage program, while maintaining a range of choices and benefits for its members.

Dr. Faller said, “For Highmark specifically, they’re a perfect example of willingness to negotiate with us, and they have a number of plans where we still fit in those plans confidently.”

Roswell Park Comprehensive Cancer Center has posted this information on their website.