A bipartisan group of House members from New York says an ongoing probe of a health care program for some 9/11 first responders and survivors shows the program “consistently struggled,” and the members are demanding details about a multimillion-dollar contract that brings in a new company to manage it.
In November, NBC News broke the news that LHI — the company responsible for administering World Trade Center Health Program benefits for 9/11 first responders and survivors who live outside metropolitan New York — had lost its government contract to Managed Care Advisors (MCA)-Sedgwick. An NBC News investigation in September reported concerns from nearly two dozen 9/11 first responders and survivors served by the program.
At the time, 9/11 responders and survivors — as well as current and former employees — said the program was failing to pay medical bills, providing inadequate treatment options and neglecting to address the needs of a population with significant rates of post-traumatic stress disorder.
Two Democrats and a Republican from New York have now sent a letter, obtained by NBC News, demanding documents from the National Institute for Occupational Safety and Health, or NIOSH, a subagency of the Centers for Disease Control and Prevention that oversees the World Trade Center Health Program. According to the letter, NIOSH officials told House staff members in a briefing in January that they were “unable to provide specifics” about the transition between LHI, now known as OptumServe Health Services, and MCA-Sedgwick, a Maryland-based government contractor that specializes in workers’ compensation.
“We are seeking to ensure that issues uncovered through investigative reporting and our own inquiry that impacted the previous contract do not reoccur,” wrote Reps. Carolyn Maloney, D-N.Y., Jerry Nadler, D-N.Y., and Andrew Garbarino, R-N.Y.
NIOSH has indicated that the transition between firms could take place as early as “late spring 2022.” The lawmakers have asked for the documents by April 4.
In August, the House Judiciary and Oversight and Reform committees launched a joint inquiry into the health program’s service of responders and survivors who can’t use New York City-area hospitals but who suffer from 9/11-related illnesses like lung disease and post-traumatic stress.
“Information obtained in our inquiry raised additional questions about OptumServe’s poor performance and its repeated failures to meet certain performance thresholds,” the representatives wrote.
The lawmakers are now asking NIOSH for detailed transition plans and an analysis of how the change in contractors will affect responders’ and survivors’ health coverage.
When NBC News first reported that the company then known as LHI lost the contract last year, a spokesperson for the company said: “LHI has been honored to be a trusted partner to NIOSH and the World Trade Center Health Program for more than a decade. Our team will continue to provide the highest level of service and care to health program members during the remainder of our contract.”
In response to the allegations from responders and survivors that were reported in September, an LHI spokesperson said the company is “committed to treating every individual we serve with care and compassion” and that it would “carefully review” members’ concerns.
The Wisconsin-based company had held the contract since 2008. It was last renewed in 2016 for more than $38.7 million.
Several responders and survivors affected by the changes said they are aware their program administrator will be changing later this year but that they haven’t been made aware of any further details about the transition.
“I haven’t received specific information on what to do,” said Terry Brooks, a former 9/11 volunteer responder who is served by the program.