Latest news with #MedicalIndemnityFund
CBS News
2 days ago
- Health
- CBS News
New York state quadruples funding for Medical Indemnity Fund. Here's why there are still concerns.
N.Y. program for children injured at birth by medical malpractice gets more funding N.Y. program for children injured at birth by medical malpractice gets more funding N.Y. program for children injured at birth by medical malpractice gets more funding It's a win for children injured at birth by medical malpractice in New York. Earlier this year, the state set aside just $52 million for a critical program — far short of what it needs to stay afloat. But after CBS News New York investigator Mahsa Saeidi pressed state leaders, the funding quadrupled. Still, families who rely on the program remain on edge. Medical Indemnity Fund faces projected $3 billion shortfall David Diaz's daughter Jhudelisse suffered a neurological injury in the delivery room, but New York state didn't allow the family to collect full damages from the hospitals found to be negligent. Instead, the state promised to provide lifelong health care through a unique program called the Medical Indemnity fund (MIF). Right now, roughly 1,000 kids are enrolled in MIF, and lawmakers say approximately 100 new kids come into the fund each year. In July 2024, Diaz told Saeidi that MIF was increasingly denying his daughter's claims. "Every year it gets tougher and tougher to get the same services we're getting now," he said at the time. Then, without warning, MIF briefly shut its doors to new enrollees. The program is financially unstable, facing a projected $3 billion shortfall. Families say the state mismanaged MIF and is now cutting corners. Despite its abrupt closure in May 2024, neither Health Commissioner James McDonald, who oversees MIF, nor the governor proposed any reforms or additional funding in 2025. In February, the commissioner told lawmakers MIF would likely run out of cash again, triggering another shutdown, but two months later, when Saeidi had a chance to speak with him, McDonald had a different outlook. "The fund needs to be reformed, but I'm pleased with what I'm seeing so far in the process. In other words, the legislature's interested in making it sustainable. Same with the governor. I am as well," he said. "So I think we're going to end someplace well at the end of this year, but we'll see where we go. But I don't anticipate it shutting down this year." Additional funding should keep program open until July 2026 Soon after, the state quadrupled MIF's funding from $52 million to $211 million, preventing a shutdown. "The reality is, without the help of people like you, we would never have had this happen. And of course it's a win," Diaz told Saeidi. But he's still concerned. "We have an opportunity to cover our kid's health costs for another year or two. And we'll see from there," he said. The state says this money should allow the fund to keep its doors open until July 2026. State Assemblyman Matt Slater calls the additional funding a "very strong half step." He says he's repeatedly reached out to McDonald to collaborate and find a more long-term solution, but he's never heard back. "The process itself is still broken. And so, we still are throwing money at a bad process," Slater said. Slater said in order to fix MIF, the process has to be streamlined. "Making sure that there's an ombudsman or a panel for the families," he said. Father believes MIF is trying to cut reimbursement Diaz said an ombudsman would be useful. "It's a way to challenge when we get denied for reimbursements," he said. He added, "I have plenty of medical expenses that should be reimbursed, but it's not being covered." Before a medical visit, therapy or treatment, Diaz must obtain prior approval from MIF. Documents show MIF just added new language stating, "This approval does not guarantee rates of reimbursement." Diaz believes the wording was changed in order to cut reimbursement. "I mean, what other reason would there be?" he said. But a health department spokesperson said this language was just added "for awareness, not as a change in policy." The spokesperson also said by law, reimbursement rates are, and have always been, subject to adjustments.
CBS News
09-04-2025
- Health
- CBS News
Families in New York's Medical Indemnity Fund desperate for much-needed help to keep program afloat
New York state promised children injured at birth by medical malpractice lifelong health care, but many families tell CBS News New York the very program created to provide that care is failing . Investigator Mahsa Saeidi has investigated issues with the Medical Indemnity Fund, or MIF, for months . The purpose of the fund is to protect hospitals by limiting their liability for medical malpractice expenses, which can be crushing. Last year, Gov. Kathy Hochul acknowledged the importance of the program, but now she's not providing enough funding to keep it afloat. Some families enrolled in the MIF say the fund is increasingly denying claims , and last year, it abruptly shut its doors to new enrollees. The $52 million appropriated by the state wasn't enough. The fund needed $110 million to keep up with rising costs. The governor transferred the money and promised CBS News New York a full review. "This is a very important fund. I agree with the families that we need to continue this," Hochul said in September. "So, all these decisions are made in the context of the budget." But when her budget dropped in January, once again, only $52 million was set aside. At a hearing in February, Health Commissioner James V. McDonald acknowledged the MIF will likely run out of cash. "If there isn't additional investment in this year's budget, then the fund will not be solvent more than likely," he said. State Assemblyman Matt Slater, who represents parts of Westchester, pressed McDonald about the fund. "Why didn't the governor propose additional MIF funding or any substantial reform of the program for the upcoming state fiscal year?" he asked. "I think the optimal approach is to work together and try to collaborate on solutions," McDonald said. "Was there any meaningful reforms proposed in the executive budget dealing with MIF?" Slater asked. "So, one of the things we've learned is that you don't love policy proposals in the budget, my friend," McDonald said. In Albany, Slater told Saeidi, "There's plenty of policy in the budget. It's called Article 7 language, so honestly it's just complete BS." "You're only coming up with half that money ... that's a failure of leadership," Slater added. Right now, there's about 1,000 families in the fund. Others who are structuring their malpractice settlements are also dependent on the fund's continued existence. But will it be there? The health commissioner would not discuss the fund or its future with Saeidi, leaving families desperate for reforms waiting and watching what happens this legislative session. CBS News New York asked the governor's office why she's not fully funding the program. In response, the governor's deputy press secretary said, "Governor Hochul continues to negotiate in good faith with the Senate and Assembly to pass a budget that makes New York safer and more affordable." Unless hospitals start to pay more into this fund, it's possible the government may sunset the program. If it does shut down, new families not in the fund yet would be able to seek full legal recourse against hospitals, according to the governor's budget. Charles Dieteman suffered a neurological injury at birth. "I didn't take a breath or have a heartbeat until 11 minutes old, so it was doctor's error that caused cerebral palsy," he said. His family sued the providers for medical malpractice in court and won, but a unique New York law barred them from collecting full damages from the hospital. Instead, Dieteman got a partial award. Then, the state enrolled him into the MIF. "It's a fund for kids and adults with special needs. We're not getting the proper health care," Dieteman said. Dieteman said he struggled to get help when he got sick last year. "Everyone's like, you need a GI doctor, you gotta see a GI doctor, well," he said. "Them saying, 'Sorry, we can't see you because we don't know what your insurance is.'" Dieteman is supposed to get care through the MIF, but because he was unable to secure a specialist through the fund, he says he repeatedly had to go to the emergency room for treatment. His mom, Tara McLellan, remembers a particularly dark day. "That day, he told me he wished he could die," she said. "I recently just got bills in the mail in my name for, like, $20,000," Dieteman said. "'Pay out of pocket and you'll get reimbursed.' What if I don't have the money to pay out of pocket?" "Before we took action and had a lawsuit and became members, enrollees in this fund, he got medical care. So, to me, very often, this feels like it's a punishment for holding the hospital accountable," McLellan said. Dieteman said he wants to tell the governor the way the MIF is set up is wrong.
