NY Presbyterian For Years Denied Easy Access to its Services For 9/11 Responders and Survivors
Under public pressure, they have finally reversed their policy and will now allow WTC Health Program members easy access.
All the major hospitals in the New York Metropolitan area have been allowing for easy access to their facilities for injured and ill 9/11 responders and survivors who get medical treatment from the World Trade Center Health Program, all except for NY Presbyterian, one of the largest hospitals in the world.
Every major medical provider in New York has what is called a “Master Agreement” or an equivalent agreement, that allows responders and survivors who are in the WTC Health Program to easily access their medical services, but for years NY Presbyterian has refused to participate, refused to sign a “Master Agreement”. They only allowed what are called “Single Use Agreements” which are cumbersome contracts that apply to only one 9/11 Responder or Survivor at a time and almost always means delays in accessing services as it would take weeks to write the contract and many times services are left off causing the responder or survivor to have to use their private insurance and incur co pays.
This was problematic because NYP provides certain specialized services that the sickest 9/11 responders and survivor need, especially Lung and Liver transplants so they have no choice but to wait because of these delays and pay copays even though that is not what is supposed to happen under the program.
This had been brought to the attention of the leadership of NY Presbyterian, starting in 2014, but for years the leadership of NYP refused to change their policy or even acknowledge the problem.
In March of 2021, Members of Congress, Carolyn Maloney, (D-NY) Jerrold Nadler (D-NY) and Andrew Garbarino (R-NY) , leaders in the New York Delegation in supporting 9/11 responders and survivors wrote on March 11th to the President of New York Presbyterian, Steven Corwin. Their letter which can be viewed here, states in part:
We are concerned that the “Single Case Agreement” model currently in use generates excessive administrative burdens that delay access to lifesaving care for 9/11 responders and survivors, as well as increased costs for the WTC Health Program, which has been established to serve this population. This model results in case-by-case agreements allowing an individual WTC Health Program member to seek care from only one specific provider at a time. Consequently, every time that a new WTC Health Program member needs care from NYP, a “Single Case Agreement” must be prepared, submitted, and approved by all parties. Furthermore, each time that a WTC Health Program patient needs a test or consultation with a different provider at NYP, a separate “Single Case Agreement” must be drafted, reviewed, and agreed to by all parties. Should a provider with the WTC Health Program decide that a WTC Health Program member needs to receive treatment at NYP, it could take weeks for the patient to receive approval for care as the referring provider must first contact the WTC Health Program for a referral and authorization. At that point a “Single Case Agreement(s)” must be drafted, reviewed by all parties, and approved. This process results in significant delays, reducing the quality of care and the quality of life for WTC Health Program members.
The letter goes one to state the impact of this policy:
Unfortunately, these administrative barriers have resulted in both patient visit cancellations and unresolved service claims. These unpaid claims then become the financial responsibility of the WTC Health Program member – a financial burden they are not meant to bear – as the WTC Health Program does not have the legal authority to pay providers outside its network of affiliated providers. In several instances, WTC Health Program members have been forced to go outside of the Program and engage in protracted negotiations with their private insurance company to cover medical fees that otherwise would have been covered by the WTC Health Program. This is antithetical to the purpose of the WTC Health Program and the care we owe these first responders and survivors.
New York Presbyterian Hospital President Steven Corwin responded to the Members of Congress on March 30th, 2021, a copy of his letter can be viewed here. Mr. Corwin states in his letter:
To our knowledge, no patient has ever been turned away or had difficulties accessing our services.
NYP flatly denied that 9/11 responders and survivors are having problems, delays in accessing care, being forced to use their own insurance and pay out of pocket expenses and states that they were unaware of this problem.
We know that that was not the case.
On August 22nd, 2021, the NY Daily News published an article titled, “NYC hospital doesn’t take federal payments to treat sick 9/11 first responders” by Michael McAuliff. You can view the article here.
In the NY Daily News Story, Dr. David Prezant, the Chief Medical Officer at the Office of Medical Affairs for the Fire Department of the City of New York (FDNY) and the Director of the FDNY World Trade Center Health Program Clinic, describes the impact of NYP’s policy.
“New York-Presbyterian accepts the Medicare fee schedule, but refuses to accept the World Trade Center Health Program fee schedule,” said Dr. David Prezant, the Fire Department’s top doctor and director of its 9/11 health program, noting that the World Trade Center program pays 15% to 20% higher rates than Medicare.
“Given that every other hospital in the metropolitan area accepts this fee schedule, this is a very unusual situation,” Prezant explained.
“These are police and fire and communication workers and responders and survivors who deserve equal access to health care,” Prezant said, adding that responders who live near New York-Presbyterian facilities, or who need the specific services that the hospital excels at, such as transplants, don’t have equal access to care.
“We even have hospitals throughout the United States that provide access — equal access to health care — to our patients, when in fact, New York-Presbyterian does not. So that is just unfathomable,” Prezant said.
“They claim that they are willing to make exceptions for someone who has a unique circumstance — and they have, they absolutely have,” Prezant explained. “But this creates a huge barrier for care because there needs to be a whole bunch of approvals to get that acceptance. And it creates an immense stress — and financial stress — to the patients.”
The doctor explained that every step of the process and every test and doctor has be approved. If every process, test and doctor visit is not approved, it can lead to a financial disaster for the sick responders.
“An isolated approval for one particular doctor or one particular test means that you’re going to be getting tons of bills from other doctors and other tests that you require during that hospital admission,” Prezant explained. “And they may not be covered because their approval was only for that isolated issue.”
New York-Presbyterian’s system can envelop patients “in a financial mousetrap,” Prezant said.
But even after this press report NY Presbyterian continued to refuse to even acknowledge the impact their policies are having and even acknowledge that 9/11 responders and survivors are being impacted.
From the Daily News article here is the response from the Hospital President Steve Corwin, ( the highest paid Hospital administrator in the New York area)
The hospital’s response to the lawmakers provided no explanation as to why the hospital chain has been unwilling to sign on. Hospital President Steven Corwin said in late March that 9/11 patients were welcomed. “No patient has ever been turned away or had difficulties accessing our services,” Corwin told the politicians, adding that the hospital has “dedicated staff to work with the World Trade Center Health Program patients in need of specialty care.”
911 Health Watch knew this was NOT true and took on the task of finding 9/11 responders or survivors whose care was delayed and or had to pay co pays this policy and would come forward.
On April 14th, 2022, the Daily News published another article, directly refuting President Corwin’s assertions. In the article “Ground Zero survivors battle New York-Presbyterian Hospital which won’t accept 9/11 Health Program” again by Michael McAuliff . You can view the article here. In the article two 911 responders told the Daily News about their NYP experiences, Walter Clark and Charlie Buttacavoli. While they were happy with the care that they did receive, they explained the bureaucratic burdens and problems that they had and the fact that they both had make out of pocket payments.
When confronted by the fact that their policies were harming 911 responders, directly contradicting the assertions of their President NYP could only respond thru a spokesperson:
A spokesman for New York-Presbyterian did not directly address the logistical and costly difficulties for sickened responders. He hinted at the lack of progress, saying only, “We are continuing to work on this issue and hope to have an update soon.”
Only after the NY Daily News Editorial Board took NY Presbyterian to task with their Editorial on April 16th, “Do no harm: NewYork-Presbyterian owes 9/11 health victims better treatment. “ You can view the editorial here.
And they called on the Chairman of the NYP Board of Directors Jerry Speyer to intervene:
This disturbing situation began in 2014 and was flagged more than a year ago by Reps. Carolyn Maloney, Jerry Nadler and Andrew Garbarino, who wrote to the hospital’s CEO, Dr. Steven Corwin. He assured them that it would be fixed. As the Daily News made clear last summer, it wasn’t. The News wrote about it again yesterday. Must the Board of Trustees, chaired by Jerry Speyer, have to get involved to straighten it out?
That NYP President Corwin and the leadership of NYP reversed course.
On April 22, 2022, NY Pres finally after over 8 years of denial admitted that 9/11 responders and survivors were denied easy access to their facilities, and many were improbably charged for co pays.
In the article, again written by Michael McAuliff titled “New York-Presbyterian finally agrees to accept World Trade Center Health Plan for 9/11 survivors.” You can view this article here.
New York-Presbyterian, the top hospital in New York that had refused to accept payments from a federally funded program that aids sick 9/11 survivors, finally relented after the Daily News reported the ongoing bureaucratic challenges for Ground Zero patients seeking treatment.
Not only are they finally admitting that their policy was wrong and have agreed to finally to sign a “Master Agreement” with the WTC Health Program but they are committing to pay any out of pocket expenses that WTC Health Program Members may have been improperly charged while using their facilities for treatment.
In an email to the News, a spokesman for the hospital acknowledged that they are reaching out to the sick responders — including former high-voltage lineman Charlie Buttacavoli and ex-NYPD traffic supervisor Walter Clark — and will ensure they are repaid for any improper charges.
“A very limited number of patients received bills in error,” said spokesman Tony Chau. “We will reimburse them for these bills. These responders and survivors have our full apology, and we will be reaching out to them immediately.”
The article goes on to quote the Hospital spokesperson:
…..also said the hospital had designated a special ombudsman who can be reached at (866) 833-6437 to work directly with all 9/11 first responders and survivors to ensure any issues are straightened out. “Our commitment to caring for every first responder and survivor who comes to us is unwavering,” Chau said.
So, this is good news that the specialized facilities at NY Presbyterian will now be able to be easily accessed by World Trade Center Health Program Members who need it and they won’t be charged improperly for their care.
But we still need to make sure that NYP does infact reimburse those responders and survivors who received their care get reimbursed.
If you were a 911 responder or survivor in the World Trade Center Health Program, and you were charged for services when you were treated by NY Presbyterian, you could get your expenses reimbursed.
You should call New York Presbyterian at (866) 833-6437 and ask to be reimbursed.
And if you feel they are not responding and holding to their public commitment, let 911 Health Watch know.
Go here to our web respond portal and tell us your story and we will contact you directly.
911 Health Watch wants to thank Members of Congress Carolyn Maloney, (D-NY), Jerrold Nadler (D-NY) and Andrew Garbarino (R-NY) for their letter to NY Presbyterian, and their continuing commitment to 911 responders and survivors.
9/11 responders Walter Clark and Charlie Buttacavoli, who came forward and told their story, even while they are still dealing with their 911 injuries.
And Jake Lemonda, former President of the Uniform Fire Officers Association and the Fire Officers for joining in this effort.
News Articles on NYP’s denying easy access to their facilities for 9/11 responders and survivors.
Doing right by the heroes: NewYork-Presbyterian fixes its policies toward 9/11 responders and victims
NY Daily News | April 22, 2022
NewYork-Presbyterian finally agrees to accept World Trade Center Health Plan for 9/11 survivors
NY Daily News | April 21, 2022
Do no harm: NewYork-Presbyterian owes 9/11 health victims better treatment
NY Daily News | April 16, 2022
Ground Zero survivors battle New York-Presbyterian Hospital which won’t accept 9/11 Health Program
NY Daily News | April 14, 2022
NYC HOSPITAL DOESN’T TAKE FEDERAL PAYMENTS TO TREAT SICK 9/11 FIRST RESPONDERS
NY Daily News | August 23, 2021
Documents
03/11/2021 Maloney, Nadler, Garbarino Letter to NY Presbyterian
03/30/2021 NY Presbyterian Response
07/22/2021 NY Presbyterian Additional Response