State health officials want New York’s 62 counties to cover the bill after private health insurers have since April refused to pay millions in fees to private therapists under contract with local early intervention programs, local officials said Wednesday.
State Department of Health officials convened an emergency conference call Friday and said that the recently centralized state billing office, which includes paying the third-party providers on the front lines of the child-based program, failed to negotiate a deal with insurance companies to pay the providers.
More than $24 million is owed statewide to physical therapy, speech therapy and other specialists, officials said.
Washington County Department of Health Director Patti Hunt said Wednesday that her county would be on the hook for $52,000 if its Board of Supervisors complied with the state request.
But supervisors quickly panned the idea.
“These rocket scientists in Albany come up with this brilliant idea and then these boobs want us to pay for it,” said Salem Supervisor Seth Pitts, a member of the county board’s Health Committee.
Warren County would be on the hook for $64,000 if that county’s Board of Supervisors ratified the state request.
“The conference call was called really quickly,” said Warren County Public Health Director Pat Auer, noting the haste at which the state was trying to push the issue.
The counties had for years been the intermediary between its early intervention providers and private insurers.
Ninety-eight percent of claims to private insurance were denied when the counties handled the deal. The counties were typically able to negotiate a settlement between the private entities and the counties were the “payer of last resort” should a deal go unreached, sometimes paying a few thousand dollars on the back end, Hunt said.
But in April, the state centralized significant portions of formerly local billing systems as part of a mandate relief initiative, as Gov. Andrew Cuomo looked to streamline social programs and Medicaid.
State officials assumed they would be able to better negotiate with insurance companies who see the programs as non-medical treatments.
“It’s not working, so now they’re coming back to us,” Hunt said.
The state is asking that each county agree to front the cash, to bring the private firms up to date, and have promised to repay local governments in the near future.
Many counties have already criticized the request and others are waiting to even see if applying tax money to settle up what’s essentially a private industry dispute is legal.
Several local providers are “hurting” because they’re owed up to $5,000 in back payments, Hunt said. Providers around the state are reportedly halting services after not being paid by either Medicaid or for-profit insurers since the state’s takeover of the social welfare program.
“I just don’t see how you take taxpayers’ money to jack up private business,” said Washington County Attorney Roger Wickes.
State regulation currently states that early intervention programs will cost the child’s parents nothing.
“If someone’s insurance company doesn’t pay, where’s the parent’s responsibility in this?” said Argyle Supervisor Bob Henke.
The Washington County Board of Supervisors Health Committee tabled the state request until a legal opinion is reached.