by Alex Birsh
MOUNT KISCO, N.Y. — After the Friday rain subsided near the entrance of the Northern Westchester Hospital in Mount Kisco, Greg Ball stepped up to the podium on the sidewalk and spoke of the bill he has been promoting to make health insurance companies become more transparent to their patients.
Senator Ball’s bill, labeled S5068/A5068, aims at trying to help families comprehend the actual coverage they purchase from companies, most notably the out-of-network expenses that have hurt at least one local couple.
Phil Kenney, the owner of a cleaning company in Bedford Hills, found his heart beating much faster than normal in April 2011, and needed to visit the Northern Westchester Hospital for assistance. While the doctors there gave Kenney what should have been a solution to his ailment, his heart acted up again, in a way “they had never seen before,” he said. Kenney was immediately transported to the Westchester Medical Center in Valhalla, where doctors gave him the surgery that slowed his heart and cured him.
Kenney and his wife Maureen were shocked to find that they were given an initial invoice of nearly $400,000 from their insurance company, which was a mistake by the company that was fixed. The new bill was $99,000, which was the correct amount.
What the Kenneys had not understood was that when Phil and Maureen left the Northern Westchester Hospital doors, their coverage stopped. Their insurance company’s reasoning to them was that the surgery that cured Phil was labeled as an elective surgery.
“It wasn’t an elective surgery, we didn’t go get Botox injections,” said Kenney. “(We) were told by the hospital that we couldn’t do the procedure here, and were moved to another location, and that’s when the ball was dropped.”
Ball’s bill will help not only those under the knife, but those who are holding it, said Dr. Thomas Lee, a neurosurgeon who practices in Tarrytown and at the Northern Westchester Hospital.
“Physicians in the state are suffering because we still have overheads to meet, employees to pay and rent to pay,” Lee said. “If you ratchet down insurance reimbursement, highly qualified and skilled doctors won’t continue to sell and then go out of the state as thousands have done.”
Ball’s bill has been through the New York State Assembly unanimously, but has yet to pass the senate floor because of hard lobbying against it by those in favor of the insurance companies, he said. But Ball is confident that 2012 will be a better year.
“The large companies have a very large and aggressive lobby. It’s a powerful one, and they have been able to bottle up this piece of legislation in previous years,” Ball said. “This is the year we’re going to get this done and come to the floor. It’s critical to protect the families like the Kenneys.” (ARTICLE)