WE PACKED THE COURTROOM AT THE APPEAL HEARING, READ ALL ABOUT IT ON OUR ACT NOW PAGE
WE PACKED THE COURTROOM AT THE APPEAL HEARING, READ ALL ABOUT IT ON OUR ACT NOW PAGE
If you want to become a firefighter, you can apply for the exam and try your shot at joining the Fire Department of New York (FDNY).
The New York City Department of Citywide Administrative Services (DCAS) released the application — which is typically offered every four years — on June 24.
And the New York Public Officers Law requires that any person employed as a firefighter in FDNY be a resident of the City of New York or of Nassau, Westchester, Suffolk, Orange,
Rockland or Putnam Counties.
There are several other requirements listed in the application.
New York City employs hundreds of thousands of people in its 80 agencies. Taking a test is the way to get started in the hiring process for most of these positions. Application fees range from $40 to $101.
The application fee for the firefighter exam is $30.
For more information about registering for this test, log onto the DCAS website. Go online via the OASys at www.nyc.gov/examsforjobs to apply. To receive monthly exam updates, sign up for the DCAS newsletter at nyc.gov/examsforjobs and click the Exams tab.
All examination and eligible list-related notifications are sent by email only; you will no longer receive notifications via U.S. mail.
DEADLINE TO FILE: 8/8/24
THE LATEST NEWS:
New York Appellate Division Affirms City Retirees’ Right to Promised Medicare Benefits
Today’s Ruling Bars City From Forcing Retirees off of Traditional Medicare
NEW YORK, May 21, 2024 — Today, the New York Appellate Division issued a unanimous decision holding that the City of New York cannot force its roughly 250,000 elderly and disabled retired municipal workers off of their longstanding Medicare insurance and onto an inferior type of insurance called “Medicare Advantage.” Unlike Medicare—a public program that has protected City retirees for the past 57 years—the City’s proposed new Medicare Advantage plan was a private, for-profit endeavor that would have limited retirees’ access to medical providers, prevented retirees from receiving care prescribed by their doctors, and exposed retirees to increased healthcare costs.
The Court confirmed what retirees have been arguing for months: that they are entitled to the healthcare they were promised for over 50 years. The Court wrote: “The City has made clear, consistent, unambiguous representations – oral and written – over the course of more than 50 years, that New York City municipal worker-retirees would have the option of receiving health care in the form of traditional Medicare with a City-paid supplemental plan. Consequently, the City cannot now mandate the proposed change eliminating that choice.”
Jake Gardener, a partner at Walden Macht & Haran LLP, counsel to the retirees, says, “We are grateful to the Court for recognizing the healthcare rights of retired City workers. Because of the Court’s thoughtful, well-reasoned decision, hundreds of thousands of senior citizens and disabled first responders will be able to receive the medical care they desperately need.”
Marianne Pizzitola, President of the New York City Organization of Public Service Retirees, one of the lead plaintiffs, states, “Retired City workers dedicated, and in many cases risked, their lives for the City for relatively low pay. In return, they were promised certain basic healthcare benefits when they retired. The City’s attempt to break that 57-year promise is shameful and, as the Court ruled today, unlawful.”
Steve Cohen, a partner at Pollock Cohen LLP, also counsel to the retirees, says, “The City owes these retirees a debt of gratitude for their service. Instead, it has been trying to deny them the healthcare they were always promised. Fortunately, retirees fought back and they won.”
[LET'S HOPE THE CITY WILL NOT BE GRANTED AN APPEAL-
CHECK BACK SOON TO SEE WHAT HAPPENS]
WE WON!!! (But still waiting to see if the City will be granted another Appeal)
On March 21, 2024 we had oral arguments and today, May 21, we were given a unanimous decision. We thank all of you for believing in us and our legal team. Without all of you, we would never have got this far. The Court said, the City cannot take away our Medicare Supplement.
This is the exact decision, "Accordingly, the judgment (denominated an order) of the Supreme Court, New York County (Lyle E. Frank, J.), entered September 19, 2023, which, in this hybrid proceeding-class action brought pursuant to CPLR article 78, granted the petition complaint to the extent of permanently enjoining the City respondents/defendants from eliminating petitioner/plaintiff retirees’ existing health insurance, automatically enrolling them in a new Aetna Medicare Advantage Plan, enforcing a June 30, 2023 deadline for retirees to opt out of the new plan, and implementing any other aspect of the City’s new retiree healthcare policy, should be affirmed, without costs."
CLICK HERE TO READ THE NY POST ARTICLE
CLICK HERE TO READ "THE CITY" ARTICLE
CLICK HERE TO READ THE DAILY NEWS ARTICLE
CLICK HERE TO READ THE NY POST / MSN ARTICLE
CLICK HERE TO READ THE FIRE RESCUE 1 ARTICLE
There was Legislation pending in Albany but it died on the floor. This legislation will be re-submitted on January 1, 2025.
We will keep you updated when it is time to contact your reps in Albany to get the Bill moving again.`
READ THE FOLLOWING ARTICLE FROM THE CHIEF:
Retired New York City municipal workers have scored yet another court victory in their ongoing efforts to prevent the city from switching them to a cost-saving private plan and stripping their Medigap coverage. RICHARD KHAVKINE/THE CHIEF Posted Tuesday, May 21, 2024 4:34 pm BY RICHARD KHAVKINE City retirees secured yet another court victory in their bid to keep their traditional Medicare and no-cost supplemental coverage. In a unanimous decision issued Tuesday, a State Supreme Court Appellate Division panel upheld a trial court finding that switching the retired municipal workers to a cost-saving private plan and stripping them of their Medigap coverage would break long-ago guarantees city officials made to employees. “The City has made clear, consistent, unambiguous representations oral and written over the course of more than 50 years, that New York City municipal worker-retirees would have the option of receiving health care in the form of traditional Medicare with a City-paid supplemental plan. Consequently, the City cannot now mandate the proposed change eliminating that choice,” the four-justice panel of the Appellate Division’s First Department concluded. The panel’s conclusion, upholding Manhattan Supreme Court Justice Lyle Frank’s August 2023 finding, marked the fourth time that courts have sided with the retirees. The city said it would appeal the ruling. Marianne Pizzitola, the president of the New York City Organization of Public Service Retirees, one of the lead plaintiffs in the case, lauded the decision, but called the city’s attempts to switch the retirees to a private, for-profit benefits plan “shameful and, as the Court ruled today, unlawful.” “Retired City workers dedicated, and in many cases risked, their lives for the City for relatively low pay. In return, they were promised certain basic healthcare benefits when they retired,” Pizzitola said in a statement.
The retirees’ lawyer, Jake Gardener, said he and his team were grateful for the court’s decision, which he said recognized the health-care rights of the former city workers. “Because of the court's thoughtful, well-reasoned decision, hundreds of thousands of senior citizens and disabled first responders will be able to continue receiving the medical care they desperately need and to which they are entitled,” Gardener, a partner at Walden Macht & Haran LLP and a former FDNY firefighter, said by phone. Adams administration officials have argued that shifting the retirees to a privately run plan would save the city as much as $600 million annually, with the savings derived from federal subsidies available to Medicare Advantage plans. In turn, the subsidies would help replenish the city’s Health Stabilization Fund, which supplements employee welfare funds. The city intends to pursue the matter to the state’s highest court. “The city will seek the Court of Appeal’s review of today’s ruling,” the director of public affairs for the city’s Law Department, Nicholas Paolucci, said in a statement. “The city's plan, which was negotiated closely with and supported by the Municipal Labor Committee, would improve upon retirees’ current plans and save $600 million annually. This is particularly important at a time when we are already facing significant fiscal and economic challenges." A representative for the Municipal Labor Committee, the umbrella organization of city public-sector unions, which supports the switch to a Medicare Advantage, said the heads of the various unions would be meeting with attorneys to discuss the decision. ‘Significant evidentiary support’ The decision, written by Associate Justice Ellen Gesmer, underscored “the hundreds of affidavits,” including from former city officials and medical professionals, along with thousands of pages of documentary evidence, in support of the retirees. It highlighted an affidavit by Lilliam Barrios-Paoli, herself a retired longtime city official who headed several departments, including that charged with personnel. Barrios-Paoli wrote that for decades the city’s human resources administrators had promised that retirees would have a choice of health plans and came to rely on those assurances. “The guarantee of good healthcare in retirement including the choice to participate in traditional Medicare with a City-paid supplemental plan was an essential recruiting and retention tool,” Barrios-Paoli, in a passage cited in the decision, said in her affidavit. Resuming a theme that emerged during the panel’s March 21 hearing on the matter, the decision noted that although city officials disputed claims from the retirees and health care experts, they “did not present any evidence controverting them,” and instead relied “heavily” on summary health-benefit program descriptions. “Notably, respondents submitted not a single affidavit by any City official disputing Ms. Barrios-Paoli’s statements, thus effectively conceding them,” Gesmer wrote. The justices also found that the city’s assertion, purportedly contained in a summary program description from 1989 but not included in the court record, that it reserved the right to change or even terminate benefits or health care plans was “insufficient to demonstrate that the promise was either qualified or too indefinite, as the reservation of rights was not included in any other SPD.” The panel also highlighted the retirees’ claims, in “unrebutted affidavits,” that they pursued public employment at least in part because of promises of health care, even though they could have earned more money in the private sector. “The particular manner in which the parties chose to litigate this action before [the] Supreme Court resulted in a record with significant evidentiary support for petitioners’ position and very little support for respondents’ position,” Gesmer wrote.
[12/14/23]
Medicare Advantage provides health coverage to more than half of the nation's seniors, but a growing number of hospitals and health systems nationwide are pushing back and dropping some or all contracts with the private plans altogether.
Editor's note: This article was originally published Sept. 27. It was updated Nov. 14 to reflect new contract developments between hospitals and Medicare Advantage plans, which are listed below.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.
"It's become a game of delay, deny and not pay,'' Chris Van Gorder, president and CEO of San Diego-based Scripps Health, told Becker's. "Providers are going to have to get out of full-risk capitation because it just doesn't work — we're the bottom of the food chain, and the food chain is not being fed."
In late September, Scripps began notifying patients that it is terminating Medicare Advantage contracts for its integrated medical groups, a move that will affect more than 30,000 seniors in the region. The medical groups, Scripps Clinic and Scripps Coastal, employ more than 1,000 physicians, including advanced practitioners.
Mr. Van Gorder said the health system is facing a loss of $75 million this year on the MA contracts, which will end Dec. 31 for patients covered by UnitedHealthcare, Anthem Blue Cross, Blue Shield of California, Centene's Health Net and a few more smaller carriers. The system will remain in network for about 13,000 MA enrollees who receive care through Scripps' individual physician associations.
"If other organizations are experiencing what we are, it's going to be a short period of time before they start floundering or they get out of Medicare Advantage," he said. "I think we will see this trend continue and accelerate unless something changes."
Bend, Ore.-based St. Charles Health System took it a step further and was not only considering dropping all Medicare Advantage plans, but also encouraged its older patients not to enroll in the private plans during the upcoming enrollment period in October. The health system's president and CEO, CFO and chief clinical officer cited high rates of denials, longer hospital stays and overall administrative burden for clinicians. Ultimately, the health system has decided to remain in network with four MA carriers and will not renew contracts with three.
"We recognize changing insurance options may create a temporary burden for Central Oregonians who are currently on a Medicare Advantage plan, but we ultimately believe it is the right move for patients and for our health system to be sustainable into the future to encourage patients to move away from Medicare Advantage plans as they currently exist," St. Charles Health CFO Matt Swafford said.
"I feel terrible for the patients in this situation; it's the last thing we wanted to do, but it's just not sustainable with these kinds of losses," Mr. Van Gorder added. "Patients need to be aware of how this system works. Traditional Medicare is not an issue. With these other models, seniors need to be wary and savvy buyers."
Here are 13 more recent instances of hospitals dropping Medicare Advantage contracts:
COULD THIS HAPPEN TO US? LET'S NOT FIND OUT, SUPPORT MARIANNE!
One large health system with hospitals in Virginia and Ohio this year cut off in-network access to consumers enrolled in some Anthem Blue Cross Blue Shield Medicare and Medicaid health insurance plans.
Two doctors groups with Scripps Health in San Diego are terminating contracts with private Medicare plans over concerns about payments and routine denials.
For years, hospitals, doctors and health insurance companies have squared off over how much to pay for medical services. Insurers negotiate contracts with hospitals and doctors so their customers can get lower, in-network rates at those facilities. These negotiations, usually hammered out behind the scenes, are becoming increasingly tense and public as hospitals seek adequate payments and health insurance companies attempt to check spiraling medical bills.
Experts say these disputes could be an early warning sign of more contract terminations ahead as hospitals and large doctor groups seek lucrative payments to offset inflation, healthcare workers' double-digit raises and escalating prices for medical supplies.
But for patients caught in the middle of these disputes, the results can be devastating. Some need to switch doctors or insurance plans or potentially pay higher, out-of-network rates at a time when half of Americans are struggling to afford the rising cost of medical care.
Scripps Health ended the 2024 Medicare Advantage plan contracts with two medical units, called Scripps Clinic and Scripps Coastal. The decision will affect about 32,000 patients who will either need to switch Medicare plans or find new doctors.
“We’re unfortunately on the vanguard of what I think is going to be a very ugly few years between hospitals and commercial insurance companies,” said Chris Van Gorder, President and CEO, Scripps Health.
Many contract terminations involve hospitals rejecting terms for private Medicare insurance plans, known as Medicare Advantage plans. While traditional, government-run Medicare allows enrollees to choose from a wide variety of doctors and hospitals, private Medicare plans restrict access through networks and impose some cost-sharing requirements such as copayments or deductibles.
Hospitals that are rejecting private Medicare plans say they don’t reimburse at the same levels as traditional Medicare, delay or deny care through prior authorizations or impose other limitations.
Van Gorder said Scripps' Medicare Advantage exit was a “very difficult decision” but one he had to make due to more than $75 million in annual losses. He tried to negotiate more lucrative reimbursement rates, but those talks fizzled.
While private Medicare plans are funded by government-run Medicare, they're also profitable because insurers keep a portion of those payments before paying for care, he said.
Van Gorder described private Medicare offerings as “delay, deny or don’t pay” plans. "They're in the business of making money," he said.
In 2022, a government watchdog report said private Medicare plans routinely rejected claims that should have been paid and denied services found to be medically necessary. These private plans rejected nearly one in five claims allowed under Medicare coverage rules and denied 13% of authorizations for medical services that government-run Medicare would have allowed, the U.S. Department of Health and Human Services inspector general investigators found.
Doctors and hospitals "are more willing to publicly express their frustration," Lipschutz said, because these private Medicare plans get what "many people would characterize as overpayments."
More than a half dozen other hospital systems from Bend, Oregon to Nashville, Tennessee have announced private Medicare contract terminations or lapses.
St. Charles Health System in Bend said it will end Medicare contracts next year with Humana, HealthNet and WellCare.
Mark Hallett, St. Charles' chief clinical officer, said sticking with those private Medicare plans would "result in restrictions to patient care, longer hospital stays and administrative burdens" for doctors.
We are Retired NYC Firefighters of all ranks. We meet five times per year at two locations; 901 Lakeville Road in New Hyde Park and 3051 Nostrand Ave in Brooklyn, NY. Through our Newsletter and this website we hope to keep you informed about your pensions.
Are you passionate about what we're doing? Let us know! We are always looking for volunteers to help us make our organization better for our members. We'll help you find a way to volunteer that best suits you. We're excited to have you join the team!
Whether you help through monetary donations, volunteering your time, or spreading our mission through word-of-mouth, thank you. We couldn't accomplish our goals without the help
of supporters like you.
2024 RMA Application with Lapel Pin (docx)
DownloadRETIRED MEMBER'S ASSOCIATION, INC
Fire Department, City of New York
ORGANIZED JANUARY 1ST, 1946
APPLICATION FOR MEMBERSHIP
We offer two types of Membership.
Life Membership- one time payment of $250.00 gives you a gold RMA Membership Card and our periodic newsletters.
Annual Membership-Annual dues of $25.00 gives you 1 year of membership with associated Card, and one year of issued Newsletters.
Once you have decided on
the type of Membership you desire,
download the PDF Application above,
fill out and send with your check
made payable to the RMA
and send via US Mail to:
The RMA
PO Box 1332
Baldwin, NY 11510
[Add Payment for the Lapel Pin(s) with your Dues Check]
(see Lapel Pin above-right)UPDATE AS OF 7/4/24: WE ARE IN THE PROCESS OF MAKING UP A RETIRED RIBBON AND/OR RETIRED NAME PLATE-WE WILL LET YOU KNOW THE PRICE OF IT WHEN IT IS FINISHED, PLEASE BE PATIENT-THANKS!
Both Life and Annual Members will receive Critical Instant Updates as
long as New Member provides a credible E-mail Address.
Lapel Pin, pictured above available for sale: PRICE: $6.00 for one pin or two for $10.00
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