University hospital shuns Obamacare

  • Hospital provides region's only tertiary care center and Level 1 Trauma Center.
  • According to CEO, Obamacare reimbursement rates are "below Medicare and approaching Medicaid."

Stony Brook University Hospital is rejecting eight health insurance plans offered in the county from New York’s health insurance exchange because reimbursement rates are too low.

According to Newsday, many hospitals in Long Island have also rejected some of the exchange’s plans, but Stony Brook is the only one so far to not accept any of them. According to the hospital’s website, it is the region’s only tertiary care center and Level 1 Trauma Center.

By and large, Stony Brook accepts Medicare and Medicaid along with other commercial plans.   

The problem is not localized to Long Island; Westchester Medical Center, located in Valhalla, New York, is another academic medical center that is not taking any exchange plans for the same reasons.

The CEO of Stony Brook, Dr. Reuven Pasternak, said that the rates being offered are “below Medicare and approaching Medicaid.”

By and large, Stony Brook accepts Medicare and Medicaid along with other commercial plans according to Gary Bie, the hospital’s chief financial officer.

Currently, the hospital is negotiating rates for six plans on the health exchange. They’ve also been negotiating with insurers of patients who are in need Stony Brooks’ standard of care.

One of those patients includes Kerry Wozny, 45, of Wading River. Kerry is an expecting mother who has been under the care of Stony Brook for a high-risk pregnancy. While under Stony Brook’s care, she found out that the hospital would not take their New York health plan.

Another incident occurred last week when patients outside Stony Brook’s cancer center saw a sign that read, "Stony Brook Medicine and The Stony Brook Cancer Center are not participating providers for the new Obama care health insurance plans. In addition, the new plans do not have any out of network coverage."

Ann Marie DiStefano, 57, a tonsil cancer patient from Middle Island, had a similar experience after she learned that Empire’s Blue Cross Blue Shield would not be accepted at Stony Brook.

Stony Brook offered her financial assistance, but instead, she decided to cancel her Empire plan and pay $225 more a month for plan that Stony Brook would accept.

She explained that Stony Brook was “more helpful” than many hospitals because they at least offered her an alternative. However, she was dismayed that her Empire plan wouldn’t cove her life-threatening situation.

“This was the most awful experience ever,” she said.

At this time, the State Department of Health is not negotiating contracts between providers and health plans.

Follow the author of this article on Twitter @SteveLarson

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