CHOP in negotiations with insurers as families hang in the balance over their children's care

Ongoing contract negotiations with insurance providers have the potential to impact thousands of patients at the Children’s Hospital of Philadelphia (CHOP).

CHOP is currently in negotiations with AmeriHealth Caritas/Keystone First. If a new agreement is not met by July 1, CHOP hospitals, CHOP doctors and CHOP Home Care will no longer be in network.

"This isn’t okay, you know, to change your insurance company or to leave the providers that have been saving your child for the last 14 years – like that’s insane. That’s a really hard decision to make," said parent Leslie Proffitt.

Proffitt’s daughter Lily Ciechoski has spastic quadriplegic cerebral palsy and epilepsy. The 14-year-old has been a CHOP patient since she was born.

Proffitt launched a petition urging insurance providers to keep CHOP in network. As of May 14th, it had over 2,255 signatures.

She has also received support from state legislators including State Representative Paul Friel (D) of the 26th Legislative District who wrote an open letter to the agencies involved.

"At the end of the day what’s being perceived is we’re taking dollar signs over children’s healthcare and that’s not okay," said Proffitt.

Missy Levin said her daughter Ava relies on Keystone First’s coverage for life saving treatment. The 14-year-old was diagnosed with osteosarcoma, a rare bone cancer in her left shoulder in January 2023.

"Unfortunately, they found a lung metastasis at her six-month scan, so she is going to be needing additional treatment which is one of the reasons why I was so concerned about CHOP’s negotiation issues," said Levin. "I don’t know what the other insurance companies will cover. What if they don’t cover all of the treatments? What if everything has to end in appeal? It’s just scary."

Becky Guy’s son Kellen was diagnosed at six-months-old with an unknown leukodystrophy, a disorder of the white matter in the brain. Kellen, who is now 11-years-old, is also blind and in a wheelchair due to muscle disorders.

"This is just making an already stressful part of your life even more stressful," said Guy. "We have everything through them and have for over a decade so for me just to switch right away… this isn’t like getting a physical for your child so they can play sports. This is a multi-step situation."

CHOP provided FOX 29 with this statement:

"Discussions between Children's Hospital of Philadelphia and AmeriHealth Caritas/Keystone First are still very active, and we continue to negotiate in good faith. We participate with all other Pennsylvania Medicaid Health Plans and have a long history of successful contract negotiations with all of them, and we believe that PA children deserve the best healthcare available.  Our priority remains to continue to deliver the very best care to our patient families. We are in contact with potentially affected families and available to support them through any questions or concerns they may have."

AmeriHealth Caritas provided FOX 29 with this statement regarding Keystone First:

"Keystone First and CHOP are still in active provider negotiations. We are committed to continuing our partnership and hope that CHOP chooses to remain in-network with Keystone First — one of the region’s leading health plans for vulnerable children and families."

The current contract ends on June 30. CHOP is providing families with information on this page.