Have You Been Abused by Health Insurance Companies?
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Colleagues:
One of my goals during my term as MSSNY president is to improve communication with our members. Towards that aim, I want to encourage a dialogue that results in tangible benefits for our members.
Last Friday I met with MSSNY Counsel David Vozza, MSSNY EVP Tom Lee, MSSNY VP of Legislative Affairs Moe Auster, and MSSNY VP of Physician Payment and Practice Heather Lopez for a high-level overview of current legal and administrative hassles plaguing physician practices. We exited the meeting with a plan seeking to flip the script on the insurance companies by highlighting their abuses of us—New York’s physician healers. To do this we need to hear from you about how the insurance companies have abused you, specifically in auditing practices by the insurer or through the use of third parties such as Cotiviti. If you were recently subject to arbitrary six-year lookbacks or unfair payment recoupments based on 20 charts or fewer, or audits from commercial or managed Medicaid insurers please reach out to [email protected] with your story, including specific details of how you were wronged.
Our goal is to share these stories with key regulatory officials urging them to stop insurers from engaging in the tactics, as well as with legislators with whom our lobbying staff has been working, to pass legislation to greatly reduce the use of these insurer audits.
The politicians keep asking me why more physicians won’t practice in New York, and I believe these unfair practices, along with the intolerable Tort environment, serve as the one two punch knocking physicians out of New York. No other industry would tolerate a six-year look back on the whims of a payor, and neither should we.
These efforts, along with the fight for the gold card prior auth bill, preservation of Medicaid IDR, preventing increases in your medical liability costs, and county medical society involvement in Worker’s Compensation credentialing will serve as the focus of our efforts for the 2025-26 legislative cycle.
We need your help to provide concrete examples of these abuses, and I look forward to hearing from you.
All the best,
David Jakubowicz, MD, FACS
MSSNY President
