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Cuomo plan for early health intervention services too costly, insurers say

Posted 1/28/16

Gov. Andrew Cuomo’s proposal to require health insurers to pay for high-cost early intervention services will ultimately hurt the insured, according to the New York State Conference of Blue Cross …

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Cuomo plan for early health intervention services too costly, insurers say

Posted

Gov. Andrew Cuomo’s proposal to require health insurers to pay for high-cost early intervention services will ultimately hurt the insured, according to the New York State Conference of Blue Cross Blue and Shield Plans.

Deborah Fasser, a BCBS spokesperson, says the plan included in Cuomo’s proposed budget would shift costs from the state and localities to private citizens who purchase health insurance.

“This initiative has been proposed by the governor several times in the past only to be rejected by the Legislature, as yet another hidden tax which will ultimately increase the cost of health insurance for New Yorkers," Fraser said.

"Specifically, the proposal requires health plans to pay for certain high-cost EI services which are currently paid for by the state and counties," she said. "Unlike every other health insurance mandate, however, this proposal expressly precludes the health plan from determining whether the care is appropriate, medically necessary, and whether the provider is properly credentialed to provide the service. In other words, the health plan is not performing medical management or insurance functions, but is simply paying for the service. No different than the many health care taxes paid today, this proposal requires consumers to pay for health care programs, which would otherwise be paid for by government.

"Forcing health plans to cover the costs of the EI program, and not allowing them to determine appropriate care and control costs by utilizing in-network providers will only increase the cost of coverage, resulting in premiums becoming more unaffordable than they are today.

"Providing quality, affordable health insurance coverage for our membership is, and has always been, a priority. This proposal is nothing more than shifting additional costs onto the backs of our members,” Fraser said.