<p><span style="color: rgb(51,51,51);background-color: rgb(255,255,255);font-family: Work Sans;">Please urge your legislators to reject a State Budget proposal that would prohibit physicians from bringing claims to New York’s Independent Dispute Resolution process relating to care provided to patients insured by Medicaid Managed Care plans. This change will lead to steep health insurer payment cuts, and discourage many physician specialties from providing essential on-call emergency department care, at a time when many such departments are already frequently understaffed.  This will negatively impact access to care for Managed Medicaid enrollees throughout the state.</span></p>


Protect Access to Care for NY Managed Medicaid Patients

Keep the Independent Dispute Resolution in Medicaid Managed Care

I am writing to you to once again urge that you reject efforts to eliminate the right of healthcare providers to bring a claim dispute to the Independent Dispute Resolution (IDR) process for various public health insurance plans. I thank the Senate and Assembly for rejecting a similar proposal last year.

I am very concerned with the serious adverse impact that this change will have on New York Managed Medicaid health benefits.  I am especially concerned about New Yorkers' access to skilled specialty physician care, including access to needed and often immediate surgical care in hospitals across the State. In implementing New York’s successful surprise billing law, policymakers have regularly sought to ensure access to a fair dispute resolution process to resolve payment disputes that does not favor either physicians or health insurers. Without the ability to access this appeal process, physicians will be forced to accept absurdly low Medicaid payment rates.  I am worried about how this will negatively impact many New Yorkers' access to care, especially our most vulnerable New Yorkers covered by Managed Medicaid plans. 

Many physician specialists may be discouraged from providing essential on-call emergency department care, at a time when many such departments are already frequently understaffed. Even worse, this change will also encourage these Medicaid Managed Care plans to significantly cut fee schedules for all of their network physicians, endangering access to care for their enrollees and further threatening the viability of many community-based physician practices.

The relatively small State Budget savings of this proposal is significantly outweighed by the risk that it will harm patient access to needed emergency and post-emergency care. The Legislature recognized the importance of maintaining this appeal mechanism when they enacted last year’s Budget. Therefore, I urge you to again work to oppose this short-sighted proposal that would eliminate this important appeal right.

Thank you for your consideration.

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