New York County Forgives Public Health Debt

Officials in Essex County in New York state are reporting that they have written off more than $150,000 in debt owed to the Public Health Department after a voted by the county’s Board of Supervisors.

The debts were incurred by clients who receive home visits from county nurses as part of the Certified Home Health Agency program. The period for the write-offs covers July 2008 to June 2013.

County Manager Daniel Palmer, who said most of the losses represent unpaid co-pays for Medicare, Medicaid and private-insurance patients, said the visiting nose program bills an estimated $2 million a year. The Certified Home Health Agency program was taking on $500,000 in yearly losses at one point, although that number was brought down by internal staff efforts. Still, the program is losing another $100,000 a year, separate from billing, because Medicaid cuts its reimbursement rate by 12%, according to Palmer, who added that it now costs more to provide the services than Medicaid reimburses.

Palmer believes the Board of Supervisors at some point will have to decide whether to continue the visiting-nurse program. The debt, he said, might just be uncollectible. 

The county previously solicited bids from collection agencies/law firms but gave up the effort when no agencies would meet the county’s terms and the county discovered it would end up paying collection attorneys more than what it expected to collect. Essex County Public Health Director Linda Beers said they’re going to accept credit cards for payment in the future, and that may alleviate some of the billing problems. 

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