Urge Speaker Heastie and Majority Leader Stewart-Cousins to Overturn Backroom Deal Between Governor and Insurance Industry
Huntington Town Clerk Raia Back in Albany Today Urging Former Colleagues to Fix This Mess
ALBANY, N.Y. – May 16, 2023 – Today, Huntington Town Clerk and former New York State Assemblyman Andrew Raia (R) sent a letter to his fellow clerks statewide urging them to take immediate action to overturn a backroom deal between Governor Hochul and the insurance industry. The deal, negotiated in secret and not revealed to local and state workers and retirees until the past week, violated the intent of the “2015 Emergency No Surprises Billing Act” – a state law designed to protect residents of New York by ending the practice of surprise medical billing and ensuring that their out-of-network care would be billed at the Fair Health Standard rate.
Instead, New York State decided – without the knowledge of those impacted and circumventing our system of checks and balances – that those who have NYSHIP (the Empire Plan) would follow the federal law. Further, the Governor, in a give away to the insurance industry, has gutted out-of-network benefits in an unprecedented move that impacts more than 1.2 million state and local employees and retirees. This deal eliminated New York’s Independent Dispute Resolution (IDR) process, inserting a qualifying payment amount combined with recent changes that amount to a 300 percent reduction in Out-Of-Network reimbursements will result in high costs for NYSHIP enrollees and destabilize the states health care system
Many workers are still not even aware that this is happening effective July 1st. Union members have only begun to receive notices about the change; however, this will impact more than just workers of a one union, it affects exempt employees as well.
This decision was so egregious that the State’s Division of Civil Service had to bypass the Department of Financial Services in order to do it and failed to notify active employees, retirees, or even State Legislators and their staffs.
Over the past two days, Mr. Raia was in Albany fighting on behalf of employees and retirees, meeting with members of the State Senate and State Assembly, imploring them to pass legislation sponsored by Senator Robert Jackson Assembly Members David Weprin and John McDonald (S.5638/A. 7120 and S. 5639-A/A. 7055) will reverse this reckless decision. S.5638/A. 7120 would keep benefits as they are, reinstating the IDR. In addition, S. 5639-A/A. 7055 would protect all NYSHIP enrollees Out-Of-Network benefits and patient doctor access.
“I am here today meeting with members of both parties, in both houses, urging them to do what is right and restore healthcare access that was taken away without reasonable justification, in violation of state processes long in existence, and in secret,” said Mr. Raia. “These egregious cuts impact hard working New York State, local employees, and front-line union workers; current and retired. If these cuts to care take effect, whether a dependent goes to camp out of state, has plans to celebrate the July 4th holiday outside of New York, or if the kids of an employee go out of state to college in the fall, and there is a medical issue they would lose access to critical care if this deal is not reversed by the State Legislature. New Yorkers deserve access to quality care – wherever they are. This is unconscionable.”
“This is a cruel way to treat 1.2 million NYSHIP contract holders, especially our senior citizens. It is imperative that we address and correct this unfortunate circumstance and provide the necessary support NYSHIP policyholders are entitled to,” said Assemblyman Weprin.
All New York State enrollees and retirees expect and deserve quality access to providers and should never be subject to predatory insurance industry practices that compromise their care or relationships with their providers. New York has some of the finest medical professionals in the nation – providers that strive to bring affordable healthcare to our inner cities, suburban, and rural communities.
Letter from Mr. Raia and the Quality Care Council to clerks statewide:
An Urgent Message from Huntington Town Clerk Andrew Raia and the Quality Care Council Regarding the Drastic State Cuts to Out-of-Network Providers in the Empire Plan and NYSHIP for the Workers at the Heart of State, Cities, Towns, and Villages
I am writing this to you today not from my office in Huntington but from the New York State Capitol. No, I am not nostalgic for my days in the Assembly; instead, I am in Albany meeting with our state’s legislators on both sides of the aisle, speaking up for those who work for so many of us and keep our government, at all levels, delivering for its people.
Many of these employees are about to be dealt a huge blow in their health insurance benefits. In a deal that was negotiated with zero transparency, zero publicity, and zero human decency, New York State violated the intent of the “No Surprises Act” – a federal law designed to ensure that residents of states that did not pass legislation to end the practice of surprise medical billing were offered protections and that their out-of-network care would be billed at the Medicare rate. States that already offered such surprise billing protections, and better protected patients and their providers, were supposed to carry on the status quo.
Instead, New York State decided – in secret discussions – that those who have NYSHIP (the Empire Plan) would follow the federal law – gutting out-of-network benefits in an unprecedented move that impacts more than 1.2 million state and local employees and retirees. The move eliminated New York’s Independent Dispute Resolution (IDR) process, inserting a qualifying payment amount.
As you read this, many of those working in your offices are not even aware that this is happening effective July 1st. Union members have only begun to receive notices about the change; however, this will impact more than just workers of a one union. It affects exempt employees too, including those appointed by public officials.
This decision was so egregious that the State’s Division of Civil Service had to bypass the Department of Financial Services in order to do it and failed to notify active employees, retirees, or even State Legislators and their staffs.
But, this decision does not have to stand. Senator Robert Jackson and Assembly Members David Weprin and John McDonald have introduced legislation (S.5638/A. 7120* and S. 5639-A/A. 7055**) that would retain our hard-won benefits.
One of the best things about being a clerk is that we get to stay above the fray of the partisanship that is plaguing our political system. In that vein, I am asking you to join me today in emailing Assembly Speaker
Carl Heastie and Senate President Pro Tempore and Majority Leader Andrea Stewart-Cousins, urging them to bring these bills to the floor, pass them, and deliver them to the governor for signature before the end of session.
You can do so by clicking here.
We owe it to those who work with us every day and we owe it to the retirees who are about to face a drastic change at a time in their lives when there is little means for recourse.
Respectfully, your colleague in government,
Andrew Raia
Huntington Town Clerk, New York
*About S5638/A7120 and S5639-A/A7055
These two bills S5638/A7120 and S5639-A/A7055 are necessary to restore and protect care access to every active employee and retired public employee who rely on The Empire Plan (NYSHIP) for healthcare insurance.
S. 5638/A. 7120 restores the Independent Dispute Resolution path for nonparticipating providers, ensuring patients won’t be stuck with exorbitant out-of -pocket bills for care.
S. 5639-A/A. 7055 addresses the subjugation of the nationally acclaimed 2015 NYS Emergency Surprise Billing Act to the inferior federal Surprise Billing Act that would benefit the insurance industry over patient access to doctors, while diminishing the out-of-network benefit by drastically reducing the methodology for rate of compensation (<Medicare +275%) a substantial reduction of 300%, ultimately shifting that cost to the patient to pay out of pocket.
About The Quality Care Council
The Quality Care Council (QCC) is an organization made up of patients and their providers aimed at informing and educating citizens about their healthcare benefits. As patients, the convoluted healthcare industry can be intimidating, confusing, and frustrating. The goal of QCC is to ensure that patients and those who represent them in government know about important aspects of their healthcare, with the goal of maintaining access, quality, and affordability. https://qualitycarecommission.org/
