Westchester Medical Center Reverses Course, Says It Will Accept Affordable Care Act Insurance

Westchester Medical Center was under fire this week for having failed to reach an agreement with any of the seven insurers offering plans on the Affordable Care Act (ACA) insurance exchanges in Westchester. That changed Wednesday when hospital officials struck a deal with Empire Blue Cross to accept their ACA plan.

A spokesperson for the hospital confirmed the development in an email: “We did sign a contract with Blue Cross to accept their insurance product offered under the State’s exchange that has been set up under ACA.” They also said the hospital had never made a decision not to accept ACA insurance products, and that the hospital had been actively negotiating to obtain an adequate rate.  

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Hospitals regularly negotiate reimbursement rates with insurers before signing on to accept their plans, and Westchester Medical Center had until Wednesday failed to agree on reimbursement rates with any of the insurers participating in the exchanges, which cover residents in Westchester, Rockland, and Putnam. According to the administration, the plans did not meet the cost of care provided by the center: As a teaching hospital that provides advanced medical services, and as a public-benefit corporation with obligations to the state pension system, hospital officials contended that their operating costs are higher than other hospitals in the area.

CEO Michael Israel was quoted in the Journal News as saying, “I don’t think it’s wrong or objectionable to want to be reimbursed an amount of money to cover the costs of treating our patients.”

The hospital is not required by law to accept insurance provided under the Affordable Care Act, but it was the only acute-care hospital of 13 in the tri-county area that had not yet reached an agreement to accept a plan or plans offered on the exchanges. 

The turmoil over the center’s failure to strike a deal comes as patients covered under the Affordable Care Act confront diminished in-network hospital and doctor choices compared with traditional coverage provided by employers. Insurers say that limiting the number of in-network choices is a cornerstone of their ability to offer affordable coverage. The Wall Street Journal reported Thursday that regulators in Washington are proposing a stricter review process for plans offered by exchanges that could force ACA providers to expand their networks.

The New York State Commissioner of Health’s office said they were monitoring the situation in Valhalla.

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