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Medical center asks lawmakers for help with Fort Drum medical referrals

By CRAIG FOX | Watertown Daily Times, N.Y. | Published: January 4, 2019

WATERTOWN, N.Y. (Tribune News Service) — Samaritan Medical Center officials have asked federal lawmakers to intervene with the situation that Fort Drum soldiers and their families can no longer be referred to Samaritan Medical Practice for specialty medical care.

The decision, effective Jan. 1, follows negotiations between the Army’s health insurer, Humana Military, and Samaritan over rates. Fort Drum stated beneficiaries of the Fort Drum Medical Department Activity, also known as MEDDAC, can no longer be referred to specialists with Samaritan’s physicians and allied health professionals.

Since Wednesday’s announcement, Samaritan spokeswoman Krista Kittle said the medical center “has reached out” to U.S. Rep. Elise M. Stefanik, R- Schuylerville, and U.S. Sens. Charles E. Schumer and Kirsten E. Gillibrand to get them involved in the situation.

In a prepared statement, Sen. Gillibrand said she’s “very concerned” about the announced disruption in referrals.

“It is absolutely essential that soldiers and families at Fort Drum, as well as covered retirees, can get the healthcare they need and deserve,” the senator said. “I intend to do everything that I can to ensure that healthcare services work for the Fort Drum community.”

The specialty services affected include ear, nose and throat care, gastroenterology, hematology/oncology, pulmonary, thoracic surgery, vascular surgery, plastic surgery, orthopedics, radiation oncology, general surgery and obstetrician-gynecologist.

The change will mean soldiers and their families might have to travel outside the region — to Syracuse or further — to get referrals for care.

“It’s really concerning,” Ms. Kittle said, adding that Humana Military needs to understand the unique relationship that Samaritan, Fort Drum and the community have with each other.

Humana Military directed Fort Drum Medical Command to no longer use Samaritan for referrals, she said.

Samaritan stated Humana Military continued to pay Samaritan Medical Practice providers at reimbursement rates established by Congress and paid by the military’s former insurer, HeathNet, for a decade. It was not financially feasible for Samaritan to agree to the lower rates, Ms. Kittle said. Samaritan officials learned about the rate changes about six weeks ago. It was unclear on Thursday how many soldiers and their families are impacted by the change.

But at least one local private practice physician’s office also has decided to no longer take Humana Military referrals.

Dr. Collins F. Kellogg Jr., who runs an internal medicine office on Gaffney Drive, said he’s decided to stop taking Humana Military referrals because they are not “financially sustainable or financially sound.”

Dr. Kellogg was unaware that Samaritan was facing the same rate changes as he was when he made the decision in November.

“It’s primarily a financial decision,” he said. “It just didn’t cut the mustard.”

Meanwhile, Humana Military is working to develop contractual relationships with other local and regional area providers to ensure continuity of care, said Warren Wright, a spokesman for Fort Drum MEDDAC Public Affairs.

“We’re just trying to make sure our beneficiaries are taken care of at this point,” he said.

The Defense Health Agency, the centerpiece of the military’s health system, and Humana Military are still talking to each other “to come up with a solution,” Mr. Wright said.

The Garrison’s Public Affairs office at Fort Drum also contacted Sens. Schumer and Gillibrand, and Rep. Stefanik about the situation.

The change will impact new or changed referrals only. Patients with ongoing referrals at Samaritan will still see their current specialist until their approved care is completed, or unless a new referral or change in referral is required, according to Mr. Wright.

New referrals will still be processed, but with other in-network providers as needed.

Beneficiaries can continue to visit the Samaritan emergency room and urgent care facilities, as they are not affected by this change.

©2019 Watertown Daily Times (Watertown, N.Y.)
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