NY Presbyterian Denies Easy Access to Its Services for 9/11 Responders and Survivors

All the major hospitals in the New York Metropolitan area allow 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”, that allows responders and survivors to easily access their medical services, but for years NY Presbyterian has refused to participate. They only allow 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 takes 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 is problematic because NYP provides certain specialized services that the sickest 9/11 responders and survivors, need, especially Lung and Liver transplants.

This has been brought to the attention of the leadership of NY Presbyterian for years, starting in 2014, but for years the leadership of NYP they refuse to change their policy or even acknowledge the problem.

This year 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 on March 30th, 2021, a copy of his letter can be viewed here. Mr. Corwin states in his letter:

“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.”

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 is not the case.

Just this past August 22nd , the NY Daily News in 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.”

So, as it stands now, NY Presbyterian continues to refuse to even acknowledge the impact their policies are having and even acknowledge that 9/11 responders and survivors are being impacted.

This needs to change. NYP needs to immediately agree to a “Master Agreement “with the World Trade Center Health Program so that members of the program can get access to its medical services.

So, we need to hear from you.

If you are a 9/11 responder and survivor, who needed the specialized care that NYP could provide and you had problems getting that care and using your WTC Health Program benefits to get the care, please let us know who you are. Please contact us and tell us your story, so we can show to NYP that their policy of denial is having a real impact on your lives and your wellbeing.

Go here to our web respond portal and tell us your story and we will contact you directly.

News Articles on NYP’s denying easy access to their facilities for 9/11 responders and survivors.

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