Lance's Corner

NYSAG Reaches Agreement with Northwell for Patient Financial Assistance

Jun 5, 2024

Per the notice below, the New York State Attorney General (NYSAG) has reached an agreement with Northwell Health to provide financial assistance to low-income patients.

Attorney General James Announces Historic Agreement with Northwell to Help More New Yorkers Receive Financial Assistance for Medical Care

Agreement with Northwell Expands Eligibility for Financial Assistance, Improves Patient Access to Financial Assistance, and Limits Unnecessary Medical Debt Collection for Uninsured and Under-Insured New Yorkers

New York Attorney General Letitia James today announced a historic agreement with Northwell Health (Northwell), New York’s largest health care network, to significantly improve and expand access to financial assistance for millions of New Yorkers at Northwell facilities and clinics across the state, including all 21 Northwell hospitals.  As a result of this first-of-its-kind collaborative agreement between Attorney General James and Northwell, uninsured and under-insured New Yorkers receiving necessary medical care and earning under five times the federal poverty level, $75,300 for an individual or $156,000 for a family of four, will be eligible for free or discounted care.  Northwell has also committed to dedicating more staff to help patients apply for financial assistance and significantly reducing medical debt collection.  This agreement comes after the Office of the Attorney General (OAG) reviewed Northwell’s financial assistance program and Northwell agreed to work with OAG to improve and expand its program.

“No one should face the choice between putting food on the table or receiving medical care,” said Attorney General James.  “Too many New Yorkers delay necessary health care appointments because costs are too high, or end up saddled with debt after receiving emergency care.  This agreement will provide critical financial assistance to millions of New Yorkers receiving medical care at Northwell facilities and ease financial worries for many patients concerned about paying their medical bills.  I applaud Northwell for their commitment to expanding access to financial assistance and hope that other New York hospitals will follow their lead to expand New Yorkers’ access to necessary medical services.”

Medical debt can be a significant financial and emotional burden, and disproportionately impacts low-income patients, people who are uninsured or under-insured, communities of color, immigrants, and people with disabilities.  Even New Yorkers with health insurance often forego or delay necessary health care because of high deductibles or insufficient coverage.  Under New York’s Hospital Financial Assistance Law and state tax codes, nonprofit hospitals are required to provide financial assistance to low-income consumers and prohibit predatory debt collection.  Today’s agreement strengthens and expands Northwell’s financial assistance program beyond the requirements of the New York Hospital Financial Assistance Law to help more New York patients.  As a result of today’s agreement, uninsured or under-insured patients earning twice the federal poverty level or less will receive free medical care.  Patients earning between three and five times the federal poverty level will receive discounted medical services based on Medicaid or Medicare rates.  The OAG and Northwell worked together to simplify Northwell’s public notices on financial assistance to make them more accessible and understandable for patients.

To limit unnecessary medical debt collection, Northwell will dedicate a Medical Debt Ombudsperson to review accounts before litigation is commenced.  The ombudsperson will ensure that the patient has been given ample notice of Northwell’s financial assistance policies and the opportunity to apply for such assistance.  The ombudsperson will also ensure there is either a reasonable basis to believe the patient owes the debt, or the patient is not known to be an enlisted service person or a veteran, unemployed,  disabled, or deemed incapacitated, among other factors.  Northwell will keep these policies in place for five years and will provide annual reports to OAG and the Northwell Board of Trustees on its financial assistance program.  The agreement applies to all 21 Northwell hospitals as well as 56 Northwell clinics in New York City and on Long Island.  The Northwell clinics include:

  1. Northwell Health Multispecialty and Imaging Services in Glen Cove  
  2. Dolan Family Health Center Diagnostic and Treatment Center d/b/a Northwell Health Family Health Center in Huntington Station 
  3. John T. Mather Memorial Hospital Outpatient Rehabilitation in Port Jefferson  
  4. Outpatient Behavioral Health Services in Port Jefferson  
  5. Precision CyberKnife of New York in East Setauket  
  6. Primary Med. Care Outpatient in Port Jefferson Station  
  7. Lenox Hill Hospital Extension Clinic at MEETH in Manhattan  
  8. Pediatric & Adolescent Medicine Clinic in New Hyde Park  
  9. Manhasset Ambulatory Care Center in Manhasset  
  10. Long Island Jewish Medical Center Satellite Dialysis Center in Bellrose  
  11. Far Rockaway Treatment Center in Far Rockaway 
  12. Garden City Treatment Center in Garden City  
  13. Project Outreach Clinic in West Hempstead 
  14. Nassau Day Training Program in Elmont 
  15. Franklin K. Lane School Clinic in Brooklyn 
  16. Long Island Jewish Medical Center - Center for Advanced Medicine in Lake Success 
  17. Northwell Ambulatory Care Center - A Program of Long Island Jewish Medical Center in Rego Park 
  18. Brian Picolo I.S. 53 School Clinic in Far Rockaway 
  19. Far Rockaway H.S. Clinic in Far Rockaway  
  20. John Adams High School Clinic in Jamaica 
  21. Imbert Cancer Center in Bay Shore 
  22. August Martin High School Clinic in Jamaica 
  23. LIJMC (DSRIP) Primary Care Clinic in Glen Oaks 
  24. LIJMC Greenlawn Cancer Center in Greenlawn 
  25. Backstretch-BEST Clinic at Belmont Raceway in Elmont 
  26. Northern Westchester Hospital at Chappaqua Crossing in Chappaqua 
  27. Northern Westchester Hospital at Yorktown Imaging in Yorktown  
  28. NSUH Sleep Studies Center in Great Neck 
  29. The Irving Goldman Family Care Center in Great Neck 
  30. North Shore University Hospital at the Center for Advanced Medicine in Lake Success 
  31. NSUH Comprehensive Wound Care Center and Vascular Access Program in Lake Success 
  32. North Shore LIJ Imaging at Great South Bay in Islip 
  33. NSUH Imaging at Great Neck in Great Neck 
  34. NSUH LIJ Imaging at Syosset in Syosset  
  35. North Shore Imaging at Garden City in Garden City  
  36. NSUH Imaging at Huntington in Greenlawn 
  37. The NSUH Imaging Center at Smithtown in Smithtown 
  38. Peconic Bay Physical Therapy and Rehab Center in Riverhead  
  39. Alcohol Treatment Services in Ossining 
  40. Phelps Psychiatric Clinic in Briarcliff
  41. Phelps at Croton in Croton-on-Hudson 
  42. Imaging Extension Clinic in Dobbs Ferry
  43. South Shore University Hospital Clinic Endoscopy and Pain Management Center in Bay Shore 
  44. South Shore University Hospital Sleep Center Extension Clinic in Hauppauge 
  45. South Shore University Hospital Extension Clinic for Pre-Surgical Testing in Bayshore 
  46. Northwell Health Cancer Institute at Riverhead in Riverhead 
  47. Northwell Health STARS at Bay Shore in Bay Shore 
  48. New Dorp High School Clinic on Staten Island 
  49. Primary Care Clinic on Staten Island 
  50. Chemical Dependence Treatment Program on Staten Island 
  51. Psych/Alcoholism Treatment Program on Staten Island 
  52. Sanford R. Nalitt Institute For Cancer on Staten Island 
  53. Center for Women’s Health on Staten Island 
  54. 256 Mason Ave. Radiology on Staten Island 
  55. Canarsie Multi Service Center in Brooklyn  
  56. Port Richmond High School on Staten Island  

Attorney General James thanks Northwell for its partnership to improve access to affordable medical care for New Yorkers.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc