Dive Brief:
- Following the recent shutdown of New York health insurance co-op Health Republic, the insurer's situation turned even more dramatic when it was revealed last week the state's Department of Financial Services had put a “hold” on the processing of some Health Republic claims in order to conserve its assets and facilitate the insurer's shutdown.
- The development has left enrollees, who are supposed to be covered though November, as well as providers, in a state of worry, with some providers reportedly telling patients they can no longer participate in the insurer's network, although the state DFS notes they are still obligated to deliver services.
- Estimates by state medical groups suggest hospitals are owed more than $160 million and doctors are owed "tens of millions of dollars."
Dive Insight:
If the claims are not processed, New York hospitals and healthcare providers could be out millions. However, it's not yet clear whether that's the case.
The news of the hold was reported by Newsday last week, when Department of Financial Services spokesperson Matt Anderson told the newspaper it had ordered claims processor Magnacare to hold the processing of “most” of the insurer's claims, without detailing which ones would continue to be processed.
At the same time, Health Republic was reporting customers would remain insured through Nov. 30 and the hold was simply creating a backlog that would ultimately be processed.
In the meantime, state senators Kemp Hannon and James Seward wrote a letter to the DFS and the state health insurance exchange about their "grave concern" over how officials were handling the Health Republic shutdown.