Northwell to expand financial aid under agreement with attorney general

Northwell Health has reached an agreement with state Attorney General Letitia James’ office to provide free or discounted medical care in many of its facilities to uninsured and underinsured people making as much as five times the federal poverty level and to limit medical debt collection.

The agreement goes beyond a newly enacted state law that mandates discounted hospital medical care for those making up to four times the federal poverty level and matches the new law’s requirement of free care for people making less than twice the poverty level.

The agreement with Northwell means families of four earning up to $156,000 a year and individuals making up to $75,300 will be eligible for discounts, which increase as income decreases.

The definition of “underinsured” in the Northwell agreement matches the definition in the new state law: people with out-of-pocket medical expenses greater than 10% of gross annual income.

“No one should face the choice between putting food on the table or receiving medical care,” James said in a statement. “This agreement will provide critical financial assistance to millions of New Yorkers receiving medical care at Northwell facilities and ease financial worries for many patients.”

James said she hoped “other New York hospitals will follow their lead.”

But the nonprofit Manhattan-based Community Service Society said even with the agreement, Northwell is not as generous as other hospitals in providing financial assistance, and it criticized the attorney general’s office for bringing its own medical-debt lawsuits on behalf of state-run hospitals.

“I'm not sure why the attorney general is focusing on Northwell when the attorney general herself is bringing 83% of all the medical debt lawsuits in the state,” said Elisabeth Ryden Benjamin, vice president of health initiatives of the society, which focuses in part on health care access and economic security. “Northwell has essentially slowed down almost to a trickle. I think they're doing very few, if any.”

A report the society released last month found the five state-run hospitals — including Stony Brook University Hospital — brought 83% of medical-debt lawsuits in New York in 2023, compared with 17% for all the state’s 213 other public and nonprofit private hospitals combined. State-run hospitals filed 6,833 suits.

Benjamin said other hospital systems, including NYU Langone, already had financial assistance ceilings higher than Northwell’s.

NYU Langone offers discounts to patients in its hospitals and federally qualified health centers making up to eight times the poverty level, spokesman Steve Ritea said. For patients in other outpatient sites, discounts are available to those earning up to three times the poverty level, he said.

Northwell’s agreement applies to all its 21 hospitals, as well as 56 Northwell clinics on Long Island and in New York City.

Northwell said in a statement that it was “one of the first health systems in New York State to establish a robust financial assistance program in 2004, and has continued to strengthen its efforts over the past 20 years.”

The attorney general’s office said it reached the agreement after the office “reviewed Northwell’s financial assistance program and Northwell agreed to work with OAG to improve and expand its program.” The office would not say what prompted the review.

Northwell on Tuesday afternoon released a statement confirming it had “raised financial aid eligibility to families with annual household incomes up to five times the federal poverty level,” but spokeswoman Barbara Osborn later said it had “been 500% for years.”

The New York Times in January 2021 revealed that Northwell had sued more than 2,500 patients in 2020 for unpaid medical bills, even though almost all other private and state-run hospitals had stopped doing so in the early months of the COVID-19 pandemic. Shortly after the article was published, Northwell announced it would stop suing patients during the pandemic and would rescind its 2020 legal claims.

Under the agreement, Northwell will require patients earning 201% to 400% of the poverty level to pay between 5% and 20% of the Medicaid reimbursement rate, depending on income. Those making 401% to 500% would pay 100% of the Medicaid reimbursement rate, but that rate is far below the commercial rate, Benjamin said.

Vanessa Baird-Streeter, president and CEO of the Health & Welfare Council of Long Island, said the agreement will increase health care access.

“Medical debt isn’t merely a financial burden,” she said. “It also acts as a barrier for individuals seeking care without the means to cover medical costs.”

Under the five-year agreement, Northwell will dedicate a medical debt ombudsperson to make sure patients who owe money are aware of Northwell’s financial assistance policies before filing suit, and are not in one of several categories of patients, including veterans, enlisted service people and people with disabilities.

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.