MAYOR DE BLASIO APPOINTS FIVE BOARD MEMBERS TO NYC HEALTH + HOSPITALS

  Mayor Bill de Blasio announced the appointment of five members to NYC Health + Hospitals’ Board of Directors. Effective January 1, 2019, José A. Pagán, Sally B. Hernandez-Pinero, Anita Kawatra, Feniosky Peña-Mora, and Freda J. Wang will join the board. Pagán will serve as Chair. The new board members bring expertise from both the private and public sectors, including health policy and delivery, community development, engineering, health communications, and municipal finance and infrastructure. Board members are responsible for overseeing the strategic goals of the public health care system toward its continued transformation and growth, an agenda spearheaded by NYC Health + Hospitals President and CEO Dr. Mitchell Katz, under the leadership of the New York City’s Deputy Mayor for Health and Human Services Dr. Herminia Palacio.

The NYC Health + Hospitals Board of Directors is charged with governance and oversight of NYC Health + Hospitals, the largest public health care system in the nation. NYC Health + Hospitals serves more than a million New Yorkers annually in more than 70 patient care locations across the city’s five boroughs.

“NYC Health + Hospitals is a critical component of our city’s public health safety net system,” said Mayor de Blasio. “I welcome the expertise and experience these new members will bring to Health + Hospitals’ Board of Directors as we work toward strengthening and transforming our public health care system.”

“Today is an exciting moment for NYC Health + Hospitals. This new board will help accelerate the transformation plan we’ve launched to be a 21st century healthcare delivery system,” saidDeputy Mayor for Health and Human Services Dr. Herminia Palacio. “The skills and experiences of incoming board members will serve the healthcare delivery system well. I look forward to working with them, and I want to express my sincere gratitude to the outgoing board members for having served with dedication.” 

“We look forward to the addition of the five newly appointed board members, who will bring their own fresh perspectives and enthusiasm to the oversight of our cherished public health system,” said Dr. Mitchell Katz, President and Chief Executive Officer of NYC Health + Hospitals. “At the same time, it’s an honor to publicly the members who will complete their service to the board in December. They have each given so generously of their time and expertise over many years in support of our health system’s mission to serve all.”

Following the appointment of the board members in January, the NYC Health + Hospitals board will consist of 16 members. The full board will include: Dr. Mitchell Katz, President and CEO of NYC Health + Hospitals; Dr. Herminia Palacio, Deputy Mayor of Health and Human Services; Dr. Oxiris Barbot, Acting Health Commissioner; Steven Banks, Commissioner of the Human Resources Administration; Dr. Gary S. Belkin, Executive Deputy Commissioner of Health-Mental Hygiene at the Department of Health and Mental Hygiene; Helen Arteaga Landaverde; Josephine Bolus; Dr. Vincent Calamia; Gordon J. Campbell; Barbara A. Lowe; and Robert F. Nolan.

“Joining the board of NYC Health + Hospitals is an incredible honor, particularly because I’ve dedicated my career to helping people get better access to health care,” said José Pagán. “I would like to extend my gratitude to Mayor de Blasio for this appointment, and I look forward to working with my fellow board members to improve New York City’s public healthcare system.”

“I am grateful that Mayor de Blasio has asked me to support his efforts to ensure that all New Yorkers have access to quality health care,” said Sally Hernandez-Piñero. “As the largest public provider of health care in the nation, it is critically important that we continue to elevate NYC Health + Hospitals’ ability to fulfill its mission.”

“As a native New Yorker who has spent much of my professional life working to advance global health in areas of unmet medical need, it is an honor to be serving the nation’s largest public health care system here at home,” said Anita Kawatra. “I thank Mayor Bill de Blasio for this appointment and for his leadership in health and human services, and I look forward to working with fellow board members to advance the mission of NYC Health + Hospitals.”

“NYC Health + Hospitals serves an incredibly important role in our city, and I am honored to contribute any way I can to the mission of the organization,” said Feniosky Peña-Mora. “I would like to thank Mayor de Blasio for his trust and look forward to working with both current and incoming board members in advancing the transformational goals of this venerable institution.”

“It’s an honor to join an organization that strives to improve the lives of New Yorkers every day,” said Freda Wang. “I would like to thank Mayor de Blasio for this appointment and look forward to bringing my experience and skills to the board and help ensure NYC Health + Hospitals continues on its path towards its ongoing transformation.”

STATEMENT FROM STATE SENATOR GUSTAVO RIVERA ON HIS APPOINTMENT AS CHAIR OF THE SENATE HEALTH COMMITTEE

"I am profoundly thankful to incoming Senate Majority Leader Andrea Stewart-Cousins for appointing me as Chair of the Senate Health Committee.

look forward to working with my colleagues, constituents across our State, and the various stakeholders in the healthcare industry to continue to improve our health indicators and outcomes, increase access to coverage for all New Yorkers, and ensure that we maintain a financially viable healthcare system.

As the White House and Republicans across the country continue to relentlessly attack our right to healthcare and attempt to dismantle the Affordable Care Act, it is urgent that New York lead by example. 

That is why I will not cease in my efforts to continue building a stronger, more efficient healthcare delivery system that treats healthcare as a right for the 20 million New Yorkers we serve."

COUNCILMAN RUBEN DIAZ, SR. INVITES THE REPARTITION OF FREE TOYS IN THE BRONX

City Councilman Rev. Rubén Díaz, Sr., along with Mr. Edward Cox, President of the New York State Republican Party and The New York Hispanic Clergy Organization will celebrate Christmas in the Bronx by distributing free toys to children.   This year this event, will take place on Tuesday, December 18, at 4:00 PM in the Auditorium of the I.S. 131 located at 885 Bolton Avenue (In the area of Story Avenue & White Plains Road in Bronx County.   The first 1,000 children between the ages of 1 to 9 years old will receive a free toy, everyone is welcome   Note: Children must be present to receive a toy.   For more information, contact Leila Martinez at 718-792-1140.

Wave Hill events December 27‒January 3

Thu, December 27

Holiday Tea at Wave Hill

Start your own holiday tradition with a luxurious afternoon tea in historic Wave Hill House. Pair it with a stroll through Wave Hill’s stunning winter gardens for a splendid, quiet celebration of the season. Afternoon Tea $36; High Tea $45. Wave Hill Members save 10%. Reservations at least 24 hours in advance, by calling 718.549.3200 x395 or emailing wavehillreservations@greatperformances.com.

Wave Hill House, NOON–2PM

Fri, December 28

Holiday Tea at Wave Hill

Start your own holiday tradition with a luxurious afternoon tea in historic Wave Hill House. Pair it with a stroll through Wave Hill’s stunning winter gardens for a splendid, quiet celebration of the season. Afternoon Tea $36; High Tea $45. Wave Hill Members save 10%. Reservations at least 24 hours in advance, by calling 718.549.3200 x395 or emailing wavehillreservations@greatperformances.com.

Wave Hill House, NOON–2PM

Sat, December 29

No Family Art Project

On the last two weekends in December, the Family Art Project will rest up for the new year. It resumes on Saturday, January 5.

Sat, December 29

Holiday Tea at Wave Hill

Start your own holiday tradition with a luxurious afternoon tea in historic Wave Hill House. Pair it with a stroll through Wave Hill’s stunning winter gardens for a splendid, quiet celebration of the season. Afternoon Tea $36; High Tea $45. Wave Hill Members save 10%. Reservations at least 24 hours in advance, by calling 718.549.3200 x395 or emailing wavehillreservations@greatperformances.com.

Wave Hill House, NOON–2PM

Sun, December 30

No Family Art Project

On the last two weekends in December, the Family Art Project will rest up for the new year. It resumes on Saturday, January 5.

Sun, December 30

Holiday Tea at Wave Hill

Start your own holiday tradition with a luxurious afternoon tea in historic Wave Hill House. Pair it with a stroll through Wave Hill’s stunning winter gardens for a splendid, quiet celebration of the season. Afternoon Tea $36; High Tea $45. Wave Hill Members save 10%. Reservations at least 24 hours in advance, by calling 718.549.3200 x395 or emailing wavehillreservations@greatperformances.com.

Wave Hill House, NOON–2PM

Sun, December 30

Garden and Conservatory Highlights Walk

Join a Wave Hill Garden Guide for an hour-long tour of seasonal garden highlights. Free with admission to the grounds.

Meet at Perkins Visitor Center, 2PM

Mon, December 31

Closed to the public.

Tue, January 1

Closed to the public.

A 28-acre public garden and cultural center overlooking the Hudson River  and Palisades, Wave Hill’s mission is to celebrate the artistry and legacy of its gardens and landscape, to preserve its magnificent views, and to explore human connections to the natural world through programs in horticulture, education and the arts.

HOURS – Open all year, Tuesday through Sunday and many major holidays: 9AM–4:30PM,  November 1–March 14. Closes 5:30PM, starting March 15.

ADMISSION – $10 adults, $6 students and seniors 65+, $4 children 6–18. Free Saturday and Tuesday mornings until noon. Free to Wave Hill Members and children under 6.

PROGRAM FEES – Programs are free with admission to the grounds unless otherwise noted.

Visitors to Wave Hill can take advantage of Metro-North’s one-day getaway offer. Purchase a discount round-trip rail far and discount admission to the gardens. More at http://mta.info/mnr/html/getaways/outbound_wavehill.htm

DIRECTIONS – Getting here is easy! Located only 30 minutes from midtown Manhattan, Wave Hill’s free shuttle van transports you to and from our front gate and Metro-North’s Riverdale station, as well as the W. 242nd Street stop on the #1 subway line. Limited onsite parking is available for $8 per vehicle. Free offsite parking is available nearby with continuous, complimentary shuttle service to and from the offsite lot and our front gate. Complete directions and shuttle bus schedule at www.wavehill.org/visit/.

Information at 718.549.3200. On the web at www.wavehill.org.

Michael Cohen Sentenced To 3 Years In Prison

U.S. Attorney’s Office Also Announces Non-Prosecution Agreement with American Media, Inc., Related to Its Payment of $150,000 to a Woman to Influence 2016 Presidential Election

  Robert Khuzami, Attorney for the United States, Acting Under Authority Conferred by 28 U.S.C. § 515, announced that MICHAEL COHEN was sentenced today to three years in prison for tax evasion, making false statements to a federally insured bank, and campaign finance violations.  COHEN pled guilty on August 21, 2018, to an eight-count information before U.S. District Judge William H. Pauley III, who imposed today’s sentence.  In a separate prosecution brought by the Special Counsel’s Office (“SCO”), COHEN pled guilty on November 29, 2018 to one count of making false statements to the U.S. Congress and was also sentenced on that case today, receiving a two-month concurrent sentence.

According to the allegations in Information 18 Cr. 602 (WHP), filed by the United States States Attorney’s Office for the Southern District of New York (the “Office”), as well as previous court filings and statements in public court proceedings:

Between 2012 and 2016, COHEN concealed more than $4 million in personal income from the Internal Revenue Service, avoiding more than $1.3 million in income tax.  COHEN also made false statements to a federally insured financial institution to obtain a $500,000 home equity loan.  Finally, in 2016, COHEN made or caused two separate payments to women to ensure that they did not publicly disclose their alleged affairs with a presidential candidate in advance of the election.  In one instance, COHEN caused American Media, Inc. (“AMI”), which was identified in previous court filings as “Corporation-1,” to make a $150,000 payment to one woman; in the other, COHEN made a $130,000 payment to another woman through an LLC he incorporated for the purpose of making the payment.  COHEN was reimbursed for the latter payment in monthly installments disguised as payments for legal services performed pursuant to a retainer, when in fact no such retainer existed.  COHEN made or caused both of these payments in order to influence the 2016 election and did so in coordination with one or more members of the campaign.

In addition to the sentence of imprisonment, Judge Pauley also ordered COHEN, 52, of New York, New York, to pay a fine of $50,000, to forfeit $500,000, to pay $1,393,858 in restitution to the IRS, and to pay a mandatory $800 special assessment.  Separately, COHEN was ordered to pay a $50,000 fine and to pay a $100 special assessment in the case brought by the SCO.  COHEN was also sentenced to concurrent three-year terms of supervised release in both cases, to follow his term of imprisonment. 

The Office also announced today that it has previously reached a non-prosecution agreement with AMI, in connection with AMI’s role in making the above-described $150,000 payment before the 2016 presidential election.  As a part of the agreement, AMI admitted that it made the $150,000 payment in concert with a candidate’s presidential campaign, and in order to ensure that the woman did not publicize damaging allegations about the candidate before the 2016 presidential election.  AMI further admitted that its principal purpose in making the payment was to suppress the woman’s story so as to prevent it from influencing the election.

Assuming AMI’s continued compliance with the agreement, the Office has agreed not to prosecute AMI for its role in that payment.  The agreement also acknowledges, among other things, AMI’s acceptance of responsibility, its substantial and important assistance in this investigation, and its agreement to provide cooperation in the future and implement specific improvements to its internal compliance to prevent future violations of the federal campaign finance laws.  These improvements include distributing written standards regarding federal election laws to its employees and conducting annual training concerning these standards. 

Mr. Khuzami praised the work of the Federal Bureau of Investigation; the Internal Revenue Service, Criminal Investigation; and the Special Agents of the U.S. Attorney’s Office. 

Three Men Found Guilty Of 2012 Bronx Murder

  Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced that SEAN PETER, a/k/a “Huggie,” JASON CAMPBELL, a/k/a “Holiday,” a/k/a “Fish,” and STEVEN SYDER, were found guilty yesterday of the murder of 20-year-old Brian Gray in the Bronx on October 2, 2012.  PETER, CAMPBELL, and SYDER were also found guilty of conspiring to distribute marijuana and related firearms offenses.  The defendants were convicted following a six-day trial before United States District Judge Naomi Reice Buchwald.

U.S. Attorney Geoffrey S. Berman said:  “For years, the defendants thought they had gotten away with murder.  Yesterday, a unanimous jury said otherwise.  We thank our partners at the FBI and the NYPD for their extraordinary work on this case, and for making sure that, no matter the passage of time, justice was done.”

According to the allegations contained in the Indictment and the evidence presented in court during the trial:

In retaliation for an attempted drug robbery, the defendants followed Gray and three friends in the early morning hours of October 2, 2012, from a local bodega to a nearby porch on Barker Avenue in the Bronx.  The defendants then left the area to arm themselves, returned to where Gray and his friends were located, and opened fire, fatally wounding Gray and injuring two other individuals. 

PETER, 35, CAMPBELL, 32, and SYDER, 35, all of the Bronx, New York, were found guilty of conspiring to distribute or possess with intent to distribute marijuana, murder in relation to a drug trafficking crime, and discharging a firearm in relation to a drug trafficking crime.  The defendants each face a mandatory minimum sentence of five years in prison and a maximum sentence of life in prison.  Sentencing of the defendants before Judge Buchwald will be scheduled at a later date.

Mr. Berman praised the outstanding investigative work of the Federal Bureau of Investigation and the New York City Police Department.  Mr. Berman also thanked the Teaneck, New Jersey, Police Department for their assistance with the investigation. 

29 ALLEGED “MAC BALLA” GANG MEMBERS AND ASSOCIATES INDICTED FOR CRIMES INCLUDING ATTEMPTED MURDER, ASSAULT, SMUGGLING SCALPELS INTO JAILS

COPS THWARTED KILLING, SEIZED .357 MAGNUM FROM DEFENDANTS 

  Bronx District Attorney Darcel D. Clark, Police Commissioner James P. O’Neill, NYC Department of Correction Commissioner Cynthia Brann and Department of Investigation Commissioner Margaret Garnett today announced that 29 people have been indicted in an enterprise of violence emanating from Rikers Island to the city’s streets, as well as other crimes. 

 District Attorney Clark said, “The defendants allegedly stoked the violence inside the jails by smuggling in scalpels and meting out slashings to inmates. They allegedly stalked robbery victims they saw wearing jewelry on social media, and allegedly ran a crack cocaine business. In a cold-blooded incident, two defendants allegedly set out to shoot a man who had an altercation with the mother of a jailed gang member. Fortunately, investigators on this case got the information, the shooting was thwarted and a loaded firearm was recovered. 

 “This case illustrates the ongoing fight to dismantle the brutal criminal network which has its hub in Rikers Island, and shows how dangerous this battle can be for our law enforcement officers. I thank them for their dedication and diligence.” 

 NYPD Commissioner O’Neill said, “Today's indictments are another product of the close partnership between the NYPD and the Bronx District Attorney's Office, which continues to make New Yorkers even safer. The people we serve will never stand for gang activity or the violence it foments, either on our streets or inside our jails. Together, we are relentless in our pursuit of true public safety in every corner of New York City.”

 DOC Commissioner Cynthia Brann said, "This investigation and the resulting indictments send a very clear message to anyone who attempts to bring weapons, violence, and drugs into our jails. You will be prosecuted if you commit crimes in custody, and if convicted you will face prison time, even if you beat the charges that originally got you here. Our Correction Intelligence Bureau works tirelessly to keep our officers and those in our custody safe, and that work takes place not only in the jails, but out on the streets, in partnership with our fellow law enforcement agencies."

 DOI Commissioner Garnett said, “Today’s indictments reflect how vitally important law enforcement partnerships are to proactively addressing crime in our City’s jails and protecting the safety of staff and inmates. This investigation successfully targeted the gang and drug activity which fuels violence on Rikers. DOI provided foundational assistance in this investigation, monitoring recorded inmate phone calls and identifying individuals attempting to engage in contraband smuggling and other dangerous criminal activity. DOI thanks the Bronx District Attorney’s Office, the New York City Police Department and the Department of Correction for their valuable partnership and commitment to pursuing crimes that threaten to undermine our City’s jail system.”

 District Attorney Clark said 13 of the 29 defendants were arrested during a takedown on December 6-7, 2018, and one was arrested on December 10, 2018. They were arraigned before Bronx Supreme Court Justice Lester Adler. Six are not yet apprehended and the remaining nine are currently incarcerated. They were variously charged in seven indictments. The defendants are due back in court on March 15, 2019.

 The investigation by the Bronx District Attorney’s Office, NYPD Bronx Gangs, NYPD Gun Violence Suppression Division, NYC Department of Correction and the NYC Department of Investigation began a year ago and involved wiretapping and electronic surveillance.

 According to an indictment, defendants Donte Joe and Michael Winn are charged with second-degree Conspiracy, Attempted Murder second-degree, and Attempted Assault and Criminal Possession of Weapon charges in the June 29, 2018 incident. The two defendants allegedly set out to kill an individual who had an altercation with defendant Althea Michelle Hogan, mother of defendant Michael Robinson. They drove to Harlem in search of the individual, and when they could not find the target they said in a phone call that they saw the target’s brother, and would “just do him in.” Police officers on patrol apparently unnerved the defendants and they headed back to the Bronx, where they were stopped by members of the investigative team and a loaded .357 Magnum revolver was recovered. If convicted of the charges, the two defendants could face up to 25 years in prison.

 According to an indictment, Jamar Williams, alleged member of the “Mac Balla” set of the Bloods who was incarcerated in Rikers Island, allegedly directed assaults on three inmates. Defendants Earin Sistrunk, Edwin Toussaint, Keith Rawlins, Jacob Ramirez, Davell Marthone and Michael Hunt allegedly slashed the faces of two “Mac Ballas” who broke gang rules, and sliced open the cheek of a Trinitarios member. He required about 26 stitches for the 8-inch gash. If convicted of Attempted Assault first-degree, they could face up to 15 years in prison. Jacob Ramirez also is charged with Attempted Assault second-degree for trying to slash a Correction Officer.

 The indictment also charges inmates and two women on the outside with conspiring to smuggle 30 scalpel blades and marijuana into the George R. Vierno Center and the Otis Bantum Correctional Center on Rikers Island and the Vernon C. Bain Center jail barge.

 According to an indictment, defendants Tashawn Murray and Rodelle Murray allegedly scoured Instagram for photos of people wearing expensive jewelry to develop potential robbery victims. In one incident, on October 12, 2018, they had a female accomplice arrange to meet a man in a hotel, and planned to rob him in the room, then go to the man’s home to steal additional valuables. Investigators alerted the man and he did not meet with the woman. A second robbery was also pre-empted.

 According to an indictment, two defendants are charged with smuggling Suboxone strips into an upstate prison. Suboxone strips are prescribed to treat heroin addiction but are misused to get high. They sold for in excess of $100 each inside Southport Correctional Facility, an ultramaximum security prison in Pine City, NY.

 Other indictments charge defendants with operating crack cocaine operations in the 42nd Precinct in the Bronx, near East 169th Street and Boston Road; and in the 46th Precinct, on Morris Avenue between East 181st Street and Burnside Avenue; and with counterfeiting twenty, and fifty and hundred dollar bills.

 District Attorney Clark thanked her Detective Investigators: Lt. Brian O’Loughlin, DI Marco Conelli, Lt. Rocco Galasso, DI Anthony DeLeon, DI Madelyn Ulerio, DI Therone Eugene, DI Gregory Maloney, DI Nicholas Cavalcanti and DI John Might; and Detective Andro Stambuk of the Bronx DA Squad, Deputy Chief Carlton Starling and Chief Frank Chiara, for their assistance in the investigation.

 District Attorney Clark thanked NYPD Detectives Adlai Pinney, Don Ramrikhi and Michael Roberts, Sergeant Leo Nugent, Lieutenant Joseph Orrechio and Captain Igor Pinkhasov of the Bronx Gang Squad; as well as Detectives Maria Lopez and John Stoltenborg, Sergeant Joe DeCandia and Sergeant Michael DeCandido of the NYPD Gun Violence Suppression Division, and Detectives Nicholas Ciuffi and Mitchell Geist of Bronx Homicide.

 An indictment is an accusatory instrument and is not proof of a defendant’s guilt.

Defendants 

Michael Robinson, 34, Bronx, N.Y. 

Damian Johnson, 56, Bronx, N.Y. 

Michael Winn, 36, Bronx, N.Y. 

Donisha Riggins, 30, Bronx, N.Y. 

Isaac Abban, 24, Bronx, N.Y. 

Sadarielle Creer, 32, Bronx, N.Y. 

Sasha Edwards, 22, Bronx, N.Y. 

Shawn Niblack, 19, Bronx, N.Y. 

Devon McFarlane, 23, Bronx, N.Y. 

Orlen Moodie, 27, Bronx, N.Y. 

Curay Gray, 23, Bronx, N.Y. 

Charisma Gonzalez, 21, Bronx, N.Y. 

Eric Summers, 27, Bronx, N.Y. 

Tashawn Murray, 25, Bronx, N.Y. 

Tyshaun Frazier, 28, Bronx, N.Y. 

Althea Hogan, 52, Manhattan, N.Y. 

Edwin Toussaint, 25, Brooklyn, N.Y. 

Erick Olegea, 20, Bronx, N.Y. 

Keith Rawlins, 29, Manhattan, N.Y. 

Rodelle Murray, 29, Bronx, N.Y. 

Defendants Already in Custody 

Donte Joe, 38, Bronx, N.Y. 

Ricky Lott, 33 

Kimani Stephenson, 26 

Michael Hunt, 33 

Earin Sistrunk, 24 

Jeffrey Simon, 36 

Davell Marthone, 22 

Jamar Williams, 32 

Jacob Ramirez, 24

A.G. Underwood Announces Settlement With EmblemHealth To Ensure Health Insurance Coverage For Gender Reassignment Surgery

As Part of Settlement, EmblemHealth Changes Coverage Criteria, Will Pay Full Restitution to Members Plus Penalties to State

  Attorney General Barbara D. Underwood announced a settlement with EmblemHealth, requiring the health insurance company to cover gender reassignment surgery for its members. An investigation by the Attorney General revealed that EmblemHealth’s process of updating criteria for gender reassignment surgery was deficient; that the criteria included in the 2014-2017 Guidelines were outdated and not medically accurate or evidence-based during the time they remained in effect; and that EmblemHealth’s review of member requests, including coverage for mammoplasty as part of gender reassignment surgery, was deficient. 

As part of the settlement, EmblemHealth has updated its Gender Reassignment Surgery Guidelines and will maintain the changes and continue to update its criteria in accordance with formal reviews. EmblemHealth will also provide restitution to members who were improperly denied coverage for gender reassignment surgery, and pay $250,000 in civil penalties to New York State.

“Health plans have a basic obligation to cover medically necessary health care for their transgender members,” said Attorney General Underwood. “My office will continue to protect the rights of transgender New Yorkers and ensure they’re treated with the fairness and dignity they deserve.”

The Attorney General’s office initiated an investigation after receiving a complaint that EmblemHealth improperly denied coverage of gender reassignment surgery to a member based on failure to meet EmblemHealth’s unlawful criteria. 

The Attorney General’s investigation revealed that between January 2014 and July 2017, EmblemHealth received 79 requests for pre-authorization of gender reassignment surgical procedures and that EmblemHealth denied 22 of those requests. The investigation found that EmblemHealth provided misleading and deceptive information to plan members indicating that its 2014-2017 Gender Reassignment Surgery Guidelines were based on current clinical information and standard medical guidelines when they were not – constituting repeated violations of Executive Law § 63 (12) and General Business Law § 349. 

As part of the agreement, EmblemHealth will provide full restitution to members who paid out-of-pocket for gender reassignment surgical procedures after denial of coverage by EmblemHealth. 

New Yorkers with complaints regarding denial of coverage for gender reassignment surgical procedures or other health-care related issues may contact the Attorney General’s Health Care Helpline at 1-800-428-9071.