 |
|
|
|
|
|
|
|
|
|
|
In solidarity,
The Bronx Democratic County Committee
1640 Eastchester Rd.
|
Tuesday, August 23, 2016
Bronx Democratic Party - Upcoming Events
R.A.I.N. Gun Hill Gets More Than $700Gs to Repair Building’s Structural Damage
This past winter, seniors at the R.A.I.N. Apartments for the Elderly on White Plains Road, Bronx, held a town hall meeting where they voiced their complaints about the lack of heat in their apartments and major structural problems with the building, including a leaky roof.
Today, the seniors learned that their complaints were heard when NYC Council Member Andy King allocated $733,161.00 for repairs to the building.
The check was presented at a follow-up town hall meeting at the R.A.I.N. Senior Center, located in the R.A.I.N. apartment building at 3377 White Plains Road., Bronx. Making the presentation before the R.A.I.N. residents was Council Member King to Anderson Torres, Ph.D, president and chief executive officer of R.A.I.N. (Regional Aid for Interim Needs, Inc.) and Evelyn Cintron, program director.
“I heard your concerns and today we’re trying to fix those concerns,” Council Member King told the seniors. “We want to stop putting band-aids on the problem.”
Both Council Member King and Dr. Torres explained to the seniors that the repairs won’t take place immediately.
“In order for us to come up with this figure we had to engage in a bidding process with contractors,” explained Dr. Torres. “Now that we have identified a company, the paperwork goes to the city for review. Once it’s been given the green light then we can start with the repairs.”
Built in 2006, more than 100 residents live at the R.A.I.N. Apartments for the Elderly on White Plains Road.
NYC Council Member Andy King (center) presents a check for $733,161.00 to R.A.I.N.'s CEO Anderson Torres, Ph.D., (immediate right), staff and residents to be used to repair structural problems at the R.A.I.N. Apartments for the Elderly on White Plains Road, Bronx.
Local Pols Prod DOT, MTA to Relocate Bus Stop On Bway & W. 230th Street
The New York City Department of Transportation (DOT) and the Metropolitan Transportation Authority (MTA) have agreed to move a Bx9 bus stop up 150 feet from its current location on Broadway near West 230th Street to better accommodate the Kingsbridge Post Office. The move was first requested in a joint letter signed by Congressman Eliot Engel, Congressman Charlie Rangel, State Senator Gustavo Rivera, State Senator Jeff Klein, Assemblyman Jeffrey Dinowitz, and City Council Member Andrew Cohen in January 2015, following a meeting with postal officials who expressed concern over the southbound stop's close proximity to the post office driveway. Following the initial refusal from the agencies to move the bus stop, Bronx Post Master Lilliam Rodriguez reached out to Congressman Engel again, at which point he reiterated the safety concerns to agency officials.
"I am pleased DOT and MTA officials have finally responded to the multiple requests our offices have made regarding the southbound Bx9 bus stop on Broadway and West 230th Street," Congressman Eliot Engel said. "This particular stop is heavily utilized by students from nearby schools who often would congregate in great numbers to wait for the bus right near the Kingsbridge Post Office's driveway. This created an unnecessarily dangerous situation for bus riders and pedestrians, in addition to making it difficult for post office employees turning in and out of the busy driveway. Though our initial request to move the stop south was rejected, I am pleased DOT and the MTA, upon further encouragement, sought to find an alternative to alleviate this hazard."
"I am very pleased that by working with the DOT, my colleagues and I were able to successfully advocate for a new stop for the BX9 bus that is away from West 230th Street Post Office," said State Senator Gustavo Rivera. "This simple change will improve the safety of pedestrians, students and our postal workers. I look forward to continue working with my colleagues to improve the transportation needs and safety of our community."
State Senator Jeff Klein said, “I am pleased to see that our concerted efforts and concerns for the safety and quality of life along the Broadway Avenue commercial corridor was agreed upon by the Department of Transportation, and as a result we shall experience a reduction in traffic congestion and increased pedestrian and motorist safety.”
Assemblyman Jeffrey Dinowitz said, “The decision by the MTA to finally move the Bx9 shows just what can get done when enough of our elected officials work together, stand up, and get involved for the benefit of the people they represent. Through a concerted effort we were able to address a situation that was both a needless danger and nuisance to our community. I’m thrilled that we were able to find a simple solution to this problem that benefits all the parties involved. My thanks to the MTA, the Department of Transportation and my fellow elected officials for coming together to address this problem head on.”
Council Member Andrew Cohen said, “It’s important for us to support improved postal operations wherever possible. We are grateful to have learned about the problems that were created by an inappropriate location for a busy bus stop right in front of the post office entrance. I was pleased to partner with other elected officials in finding a simple and workable solution that is better for students and the post office. Thanks to the MTA for implementing our plan.”
Monday, August 22, 2016
A.G. Announces Settlement With Healthnow N.Y. Over Wrongful Denial Of $1.6 Million In Outpatient Mental Health Treatment Ensuring Coverage For Nutritional Counseling For Patients With Eating Disorders
Company Will Reimburse Members Wrongfully Denied, Will Revise Policies, And Will Eliminate Practice of Automatically Reviewing All Outpatient Psychotherapy Claims Beyond Pre-Set Thresholds
Settlement Based On Alleged Violation Of Laws Requiring Insurers To Treat Behavioral Health the Same As Medical Care
Attorney General Eric T. Schneiderman today announced a settlement with HealthNow, New York, Inc., after an investigation uncovered the wrongful denial of thousands of claims for outpatient psychotherapy and more than one hundred claims for nutritional counseling for eating disorders. The wrongful denials totaled more than $1.6 million in patient claims. Under the agreement, the Buffalo-based company, a not-for profit health service corporation providing health care coverage for approximately 573,700 New Yorkers (including 291,000 who are enrolled in commercial health plans), will pay members for the wrongfully denied claims, revise its policies, and will eliminate a company policy that subjected all psychotherapy claims to review after a member’s 20th visit.
“Insurers have a legal obligation to provide the same level of care to patients being treated for behavioral health conditions as they do for patients with other ailments,” said Attorney General Schneiderman. “Individuals confronting mental health conditions, eating disorders, or substance abuse should not be denied coverage for the treatment they need and deserve.”
Attorney General Schneiderman’s Health Care Bureau launched an investigation in 2015 into HealthNow’s administration of behavioral health benefits following the receipt of consumer complaints. The complaints alleged that HealthNow had improperly denied coverage for treatments by requiring that all outpatient behavioral health visits be preauthorized after the first 20 visits per year, and by excluding coverage for nutritional counseling for eating disorders.
The Attorney General’s investigation revealed that since 2012, HealthNow conducted thousands of wrongful reviews in outpatient behavioral health cases under its 20-visit threshold, denying coverage for outpatient behavioral health services for approximately 3,100 members. HealthNow generally does not impose the same type of utilization review process for outpatient medical services.
HealthNow further denied approximately 125 sessions of nutritional counseling to members with eating disorders, on the grounds that the service was not a covered benefit. As a result, members were charged a total of approximately $14,000 for these medically necessary treatments. The company does, however, cover nutritional counseling visits for medical conditions – for example, for patients with diabetes.
Pursuant to the Attorney General's settlement, HealthNow has agreed to eliminate utilization review for outpatient behavioral health treatment based on set thresholds that trigger review, including but not limited to the 20-visit threshold it has applied since 2010. HealthNow will also cover nutritional counseling for eating disorders, including anorexia nervosa and bulimia nervosa. HealthNow will reimburse members who paid out of pocket for treatment after their claims were denied under the 20-visit threshold or nutritional counseling exclusion. Health Now will also retrain its staff regarding these significant reforms. Under the settlement, HealthNow will also pay $60,000 to the OAG as a civil penalty.
The investigation was launched under Timothy’s Law, which mandates that New York group health plans provide “broad-based coverage for the diagnosis and treatment of mental, nervous or emotional disorders or ailments … at least equal to the coverage provided for other health conditions.” N.Y. Ins. Law §§ 3221(l)(5)(A); 4303(g)(1). Timothy’s Law also requires that plans provide coverage comparable to that provided for other health conditions for adults and children with biologically based mental illness – including bulimia and anorexia – under the terms and conditions otherwise applicable under the policy. N.Y. Ins. Law §§ 3221(l)(5)(B)(i); 4303(g)(2)(A).
The New York law is similar to the federal mental health parity law, which was enacted in 2008.
Many individuals with behavioral health disorders seek outpatient treatment. According to the Substance Abuse and Mental Health Services Administration, outpatient therapy and counseling is an evidence-based treatment for mental and substance use disorders. Evidence from rigorous clinical research studies has shown that a variety of psychotherapies are effective with children, adults, and older adults, across diverse conditions. Additionally, evidence from numerous large scale trials and quantitative reviews supports the efficacy of cognitive-behavioral therapy for alcohol and drug use disorders.
Data from the National Institute of Mental Health show that anorexia nervosa is the most fatal mental disorder, with an estimated mortality rate of approximately 10 percent. Evidence-based medical guidelines confirm the important role of nutritional counseling in the treatment of eating disorders. According to the American Psychiatric Association’s Practice Guideline for the Treatment of Patients with Eating Disorders, nutritional counseling is “a useful part of treatment and helps reduce food restriction, increase the variety of foods eaten, and promote healthy but not compulsive exercise patterns,” and is an empirically supported strategy for the treatment of binge eating. The National Eating Disorder Association considers nutritional counseling “a necessary component of treatment” for eating disorders.
Consumers with a complaint regarding health insurance coverage for behavioral health treatment, or any other health care-related complaint, may always contact the Attorney General’s Office Health Care Helpline at 800-428-9071.