Health company for 9/11 first responders still falling short: advocates

The company that took over the contract to treat thousands of ill 9/11 responders around the country is still failing to do the job, advocates charge in a new letter to the firm’s parent company.

Managed Care Advisors won the contract providing medical services to some 25,000 responders in 2022, but after more than half a year still is doing a poor job, with 9/11 patients struggling to find providers, get appointments or even speak to administrators, according to advocates.

Now those advocates are trying put pressure on MCA’s corporate parent, Sedgwick, a workers’ compensation and claims processing company.

“It is our view that Sedgwick has repeatedly and continuously failed to meet its contractual requirements,” says a letter from 9/11 Health Watch Executive Director Benjamin Chevat.

The Daily News has reported previously about difficulties that ill responders and survivors have been having with the new contractor. Chevat’s letter says the problems remain.

“9/11 Health Watch has documented over 100 members who have had problems with Sedgwick,” the letter says, listing phone calls that don’t get returned, personal case mangers who can’t be reached, the unavailability of cancer doctors, improper billing, and doctors who refuse to accept Sedgwick because of past run-ins in workers comp cases.

On top of that and other problems, some 4,000 patients in the national program have doctors who used to be in the trade center health program’s national network, but have not been included by MCA/Sedgwick.

“This has caused enormous disruption and distress, especially given that many World Trade Center Health Program members had no warning of the loss of their provider,” the letter charges.

Chevat suggests that Sedgwick, which also provides medical services for Amazon workers, secured the contract by under-bidding the previous administrator, expecting to employ tactics from the workers comp system to limit payments and pocket the profit.

“Using that model, it appears that instead of ‘never forgetting’ 9/11 and the injured 9/11 responders and survivors whose health is still impacted by it every day, it appears that Sedgwick forgets 9/11 every day — by delivering abysmal service to this community,” the letter says.

MCA and officials at the branch of the Centers for Disease Control and Prevention that oversees the trade center program have acknowledged that the changeover has been problematic, but have insisted that all parties are working together to iron out the issues.

The new letter says, however, that there has been little progress, beyond some improvement in getting phone calls answered.

A Sedgwick spokeswoman emailed that “the MCA leadership team has the letter. They are in the process of contacting Mr. Chevat.” She did not address the letter’s specific complaints, but provided a statement from MCA’s president, Lisa Firestone.

“With a heightened focus on member experience, Managed Care Advisors continues to directly engage with members to ensure they get the resources needed through the benefits,” Firestone’s statement said. “Since August 2022 when Managed Care Advisors started supporting the World Trade Center (WTC) Health Program, we have made significant progress and are making sure that we are doing everything we can to support our members.”