As part of continuing oversight of the World Trade Center Health Program (WTCHP), U.S. Rep. Andrew Garbarino (R-NY) this week requested information on a new multimillion-dollar contract award to administer the program’s Nationwide Provider Network, which offers medical care to thousands of 9/11 responders across the country.
Rep. Garbarino and two of his New York colleagues want to ensure that issues uncovered through investigative reporting and their own inquiry that impacted the previous contract do not reoccur so that 9/11 responders receive seamless care during the transition to a new health care program administrator, according to a March 21 letter they sent to Dr. John Howard, director of the National Institute for Occupational Safety and Health (NIOSH) and administrator of the WTCHP.
Joining Rep. Garbarino in signing the letter was U.S. Rep. Carolyn Maloney (D-NY), chairwoman of the U.S. House Oversight and Reform Committee, and U.S. Rep. Jerrold Nadler (D-NY), chairman of the U.S. House Judiciary Committee.
According to the lawmakers’ letter, information obtained in response to their August 2021 inquiry raised questions about the performance of the federal contractor that had previously administered the WTCHP’s Nationwide Provider Network (NPN) program, Logistics Health Inc., which is now known as OptumServe Health Services.
Because the company repeatedly failed to meet certain performance thresholds, the Centers for Disease Control and Prevention in December 2021 announced it had awarded a new five-year contract to a different administrator, Managed Care Advisors (MCA)/Sedgwick.
NIOSH on Jan. 5 provided the members’ staff with a briefing on the new contract and transition plans, according to their letter, but when asked about how current program members would be directly affected by the switch in contractors, NIOSH officials reported that they were unable to provide specifics as they were still developing transition plans.
“As strong supporters of the WTCHP, we are seeking to ensure the program not only has the necessary resources but is properly administered so that members receive the high-quality care that they need and deserve,” wrote Rep. Garbarino and his colleagues. “We are continuing to closely monitor the WTCHP during this transition period and are conducting oversight over the agencies and companies responsible for running the program.”
The members requested that NIOSH provide them with information on the full NPN contract with MCA/Sedgwick; the framework of NIOSH’s Quality Assurance Surveillance Plan with MCA/Sedgwick, including a written explanation of the changes and improvements made from the prior plan; detailed transition plans, including plans to communicate changes to members; and an analysis of the overlap between provider networks and the number of WTCHP members expected to be affected by the transition.