Hospital, Oxford in battle

A more-than-year-long dispute between Jamaica Hospital Medical Center and Oxford Health Plus could have major ramifications on the future of the hospital for both patients and doctors alike.
In April of 2006, patients and doctors received letters from Oxford saying that it would no longer provide medical coverage at the hospital effective May 2, causing panic throughout the hospital.
David P. Rosen, president of Jamaica Hospital and its parent company, MediSys Health Network said “patients came running in to their doctors with their letters scared to death,” afraid they would no longer be covered at Jamaica.
“I am absolutely stunned by the callous indifference they have shown to their own members,” Rosen continued.
Shortly after receiving the letters, Jamaica Hospital filed a lawsuit in State Supreme Court in Queens, which resulted in the two sides agreeing to continue to do business until August 1.
However, the two sides give conflicting accounts as to why Oxford sent the letters to patients and doctors in the first place.
“We believe that Jamaica terminated its agreement with us,” said Maria Gordon-Shydlo, a spokesperson for UnitedHealth Group, Oxford’s parent company. She said that through a communication originating from Jamaica, Oxford believed that its agreement would no longer be in effect on May 2 so they needed to send out letters to patients and doctors alerting them to the upcoming change.
Rosen scoffed at this notion and said that officials from UnitedHealth Group told his representatives they signed the contract.
It is still unclear at this time how much money the hospital could potentially lose if the separation from Oxford – which currently accounts for eight percent of the hospital’s revenue – occurs in less than two months.
“It’s not a contract dispute; it’s not a computer glitch; there is a campaign here focused on hospitals they [Oxford] may think they can do without; people they think they can bully communities they may think don’t have the same rights, and this has to be stopped,” Rosen said.
It is still unclear what will happen after August 1, and both parties appeared hesitant to commit to the likelihood of reaching a settlement.
In late 2004, Jamaica believes it reached a new contract agreement with Oxford that called for it to pay more money to the hospital. However, according to Jamaica Hospital, Oxford continued to pay the old rates, and it asked MediSys to have a group of independent anesthesiologists who work at Flushing Hospital sign onto the Oxford network. MediSys responded that they would not comply with this request.
“Holding up one hospital to make a ploy for another hospital is completely unacceptable,” Rosen said.
State Senator Toby Ann Stavisky said she was outraged when she found out about the situation she planned to call the superintendent of the New York State Department of Insurance the following day to investigate. Stavisky said she is not sure what, if anything else, can be done at the state level to solve this problem.
“It’s almost a David and Goliath situation,” she said, “The insurance companies have gotten so powerful, you wonder who is protecting the consumer.”