Laura
04-16-2010, 09:00 PM
from The NY Daily News:
http://www.nydailynews.com/ny_local/bronx/2010/04/16/2010-04-16_hosps_feel_the_heat_group_sez_medicaid_equals_i nferior_care.html
Bronx Health REACH accuses hospitals of segregating patients based on health insurance
BY Bill Egbert
DAILY NEWS STAFF WRITER
Friday, April 16th 2010, 4:00 AM
A group claiming some hospitals segregate Bronx patients based on their insurance will hold a community meeting Saturday to raise awareness about the issue.
Bronx Health REACH accuses three major teaching hospitals of referring some Medicaid patients to clinics providing inferior care rather than to faculty practices catering to those with private insurance.
The meeting - from 10 a.m. to noon at Bronx Junior High School 22 at 270 E. 167 St. - will feature a panel of doctors and lawyers and testimony from Bronx Medicaid patients claiming they received inferior care.
One patient who will speak, Vanessa Ghigliotty, 36, was told that the lump on her side was gas when she went to her local clinic with stomach pain. Months later, when the pain sent her to the emergency room, she was diagnosed with stage-4 colon cancer.
"We have one of the most segregated medical systems in the country," charged Dr. Neil Calman of Bronx Health REACH.
New York Lawyers for the Public Interest helped document the allegations involving Montefiore Medical Center, New York-Presbyterian Hospital and Mount Sinai Medical Center two years ago by calling the hospitals' referral lines and claiming different insurance providers, then noting where the hospitals sent them.
In 2008, NYLPI filed a complaint with state Attorney General Andrew Cuomo's office claiming a two-tiered system in which Medicaid patients were consistently sent to community clinics, while those with private insurance were referred to faculty practices.
The hospitals deny the charge. Cuomo's office did not return repeated calls for comment.
Dr. Hal Strelnick, chief of community health in the Department of Family and Social Medicine at Montefiore, said that anyone who calls for a general referral would be asked about their insurance at the clinic, not on the phone.
According to NYLPI, the test callers were asked about their insurance before getting referrals.
"That [survey] was done two years ago," said Strelnick. "I doubt it could be duplicated today."
NYLPI faults the attorney general's office for not doing its own survey after NYLPI's complaint, which is one reason it helped organize Saturday's meeting.
Brian Conway of the Greater New York Hospital Association acknowledged that some disparities persist, but said Bronx Health REACH's complaint misses the point.
"Since many doctors don't participate in the Medicaid program because the reimbursement is far too low, hospitals provide outpatient clinics that accept Medicaid," Conway said.
"Yet rather than praise hospitals for delivering care where it wouldn't otherwise exist," he noted, "Bronx Health REACH criticizes them for providing it via clinics."
Read more: http://www.nydailynews.com/ny_local/bronx/2010/04/16/2010-04-16_hosps_feel_the_heat_group_sez_medicaid_equals_i nferior_care.html#ixzz0lJowMfSr
http://www.nydailynews.com/ny_local/bronx/2010/04/16/2010-04-16_hosps_feel_the_heat_group_sez_medicaid_equals_i nferior_care.html
Bronx Health REACH accuses hospitals of segregating patients based on health insurance
BY Bill Egbert
DAILY NEWS STAFF WRITER
Friday, April 16th 2010, 4:00 AM
A group claiming some hospitals segregate Bronx patients based on their insurance will hold a community meeting Saturday to raise awareness about the issue.
Bronx Health REACH accuses three major teaching hospitals of referring some Medicaid patients to clinics providing inferior care rather than to faculty practices catering to those with private insurance.
The meeting - from 10 a.m. to noon at Bronx Junior High School 22 at 270 E. 167 St. - will feature a panel of doctors and lawyers and testimony from Bronx Medicaid patients claiming they received inferior care.
One patient who will speak, Vanessa Ghigliotty, 36, was told that the lump on her side was gas when she went to her local clinic with stomach pain. Months later, when the pain sent her to the emergency room, she was diagnosed with stage-4 colon cancer.
"We have one of the most segregated medical systems in the country," charged Dr. Neil Calman of Bronx Health REACH.
New York Lawyers for the Public Interest helped document the allegations involving Montefiore Medical Center, New York-Presbyterian Hospital and Mount Sinai Medical Center two years ago by calling the hospitals' referral lines and claiming different insurance providers, then noting where the hospitals sent them.
In 2008, NYLPI filed a complaint with state Attorney General Andrew Cuomo's office claiming a two-tiered system in which Medicaid patients were consistently sent to community clinics, while those with private insurance were referred to faculty practices.
The hospitals deny the charge. Cuomo's office did not return repeated calls for comment.
Dr. Hal Strelnick, chief of community health in the Department of Family and Social Medicine at Montefiore, said that anyone who calls for a general referral would be asked about their insurance at the clinic, not on the phone.
According to NYLPI, the test callers were asked about their insurance before getting referrals.
"That [survey] was done two years ago," said Strelnick. "I doubt it could be duplicated today."
NYLPI faults the attorney general's office for not doing its own survey after NYLPI's complaint, which is one reason it helped organize Saturday's meeting.
Brian Conway of the Greater New York Hospital Association acknowledged that some disparities persist, but said Bronx Health REACH's complaint misses the point.
"Since many doctors don't participate in the Medicaid program because the reimbursement is far too low, hospitals provide outpatient clinics that accept Medicaid," Conway said.
"Yet rather than praise hospitals for delivering care where it wouldn't otherwise exist," he noted, "Bronx Health REACH criticizes them for providing it via clinics."
Read more: http://www.nydailynews.com/ny_local/bronx/2010/04/16/2010-04-16_hosps_feel_the_heat_group_sez_medicaid_equals_i nferior_care.html#ixzz0lJowMfSr