NY lawmakers request knowledge to keep away from insurance coverage overpayments

Advocates estimate that New York state could possibly be overpaying $1 billion for well being care amid a widening disparity in hospital prices relying on the place an individual receives therapy.

Some lawmakers are working to learn the way a lot.

“There’s plenty of knowledge that reveals on the whole hospitals cost prices that fluctuate wildly, and with fees or charges to sufferers and below totally different insurance coverage for actually fundamental care,” stated state Sen. Andrew Gounardes, a democrat. from brooklyn

Gounardes and State Assemblywoman Catalina Cruz, D-Queens, despatched a letter to state Civil Service commissioners and state well being departments requesting knowledge to evaluate the price of 1.2 million state employees enrolled within the California State Well being Insurance coverage Program. New York and the way a lot the state overpays its beneficiaries.

Hospital prices fluctuate extensively, and well being care prices have risen greater than 200% since June 2000, based on the American Enterprise Institute.

For instance, an MRI for somebody with out insurance coverage prices lower than $500 at Mt. Sinai Well being System in New York Metropolis, in comparison with greater than $7,400 for a affected person with well being advantages at New York Presbyterian throughout the road. .

Within the letter, lawmakers requested the Division of Civil Service a listing of questions to find out which hospital methods are overcharging for traditional procedures.

They need to know the quantity of public funds spent on the State Well being Insurance coverage Plan and worker hospital care to make sure that the state, the most important purchaser of well being care in New York, correctly manages taxpayer funds.

“That may assist us perceive how massive this drawback actually is,” Gounardes stated.

Lawmakers selected to evaluate the state’s medical health insurance program, or the info they’ve management over, to take a step towards fairness in hospital affordability. Nevertheless it is a matter that impacts all employees once they negotiate their advantages.

“What they realized within the [budget] hearings final 12 months, the state does not even monitor this info,” stated Manny Pastreich, secretary treasurer of SEIU union 32BJ.

A number of unions and well being suppliers have come collectively to type the Coalition for Reasonably priced Hospitals.

An individual with medical health insurance will pay as much as three to 4 occasions what hospitals cost the federal government for Medicare, Pastreich stated.

“We predict the state might be overpaying for well being care by a billion {dollars} or extra,” he stated. “What might the state do with a billion {dollars} for different priorities apart from overpaying for high-priced hospitals?”

Lawmakers did not give the Civil Service Division a deadline for receiving the info, however count on it might take a number of weeks because the state gathers info within the midst of the open enrollment interval.

“We’re reviewing the letter. As well being care prices proceed to rise nationally, the Division of Civil Service stays dedicated to working with state worker unions and our 1.2 million NYSHIP contributors to supply complete and inexpensive well being protection to whereas additionally defending New York State taxpayers,” based on a press release from the Division of Civil Service when requested in regards to the letter and price of the state’s well being plan.

The state Division of Well being regulates state hospitals and can’t oversee the state well being plan, and he referred all inquiries to the Division of Civil Service. The division will reply to lawmakers’ workplaces in regards to the letter to direct them to the opposite company.

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