House members from New York want info on federal contract to manage health care for some 9/11 survivors

A bipartisan group of House members from New York said in a letter sent to federal administrators on Tuesday that a health care program for some 9/11 first responders and survivors has “consistently struggled,” and asked for details about a multimillion-dollar contract awarded to a new company to manage it.

After NBC News reported the letter Tuesday morning, a spokesperson for the federal agency that runs the program, National Institute for Occupational Safety and Health (NIOSH), said NIOSH would be delaying the handover to the new company “to allow more time for a smooth transition.”

The spokesperson said the decision to extend the transition period was made prior to NIOSH’s receipt of the letter from the House members.

In September, an NBC News investigation reported concerns from nearly two dozen 9/11 first responders and survivors served by the World Trade Center Health Program, which handles benefits for 9/11 first responders and survivors who live outside metropolitan New York.

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.

In November, NBC News broke the news that LHI — the company responsible for administering— had lost its government contract to Managed Care Advisors (MCA)-Sedgwick.

On Tuesday, the House members from New York demanded documents from NIOSH, the subagency of the Centers for Disease Control and Prevention that oversees the World Trade Center Health Program. According to their letter, NIOSH officials told House staff members in a January briefing 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. 

In August, the House Judiciary and Oversight and Reform Committee 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. Rep. Maloney is chair of the committee.

“Information obtained in our inquiry raised additional questions about OptumServe’s poor performance and its repeated failures to meet certain performance thresholds,” Maloney and the other representatives wrote in Tuesday’s letter. 

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. 

NIOSH had indicated that the transition between firms could take place as early as “late spring 2022.” In their letter, lawmakers have asked for the documents by April 4.

But after initial publication of this story, a NIOSH spokesperson said the agency had “recently decided to move the transition date to late summer/fall to allow more time for a smooth transition.”

The spokesperson said that “[t]he additional time is to allow the Program to continue working with both contractors to ensure a smooth transition of healthcare services for WTCHP members.”

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.

On Tuesday, NIOSH said “no action is required at this time” from survivors living outside the New York City-area who will be affected by the transition, and that it expects most of them to be able to continue getting care from their current doctors once the change is made.

“Every effort will be made to keep NPN members’ existing providers, including mental health providers. However, if that is not possible, NPN members will be contacted later in the transition to help find a new provider(s).”

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.

OptumServe did not immediately respond to requests for comment.