HIP Medicare advantage Plan should be fined, dissolved, and its corporate executive should be jailed for the fraud they perpetrate on elderly individuals by taking their premium payments with no intention of providing reasonable health insurance commensurate with Medicare.
Consumer Complaints & Reviews
I am rescinding all comments previously made by me regarding the Meadowbrook Care Facility. As I proceed through the appeal process from a denial of continued in-patient rehab care, I discovered that the HMO HIP Emblem Health Care of NY (a medical Advantage Plan) has representatives who have consistently lied to me because they are negligent, are poorly trained, or are trained to lie. I regret all previous comments besmirching the rehab center.
My mother was admitted to short term in-patient rehabilitation at the Meadowbrook Care Center, due to a compression fracture. HIP NY Emblem healthcare (a medicare advantage plan) authorizes 100 days of treatment requiring Dr. prescriptions every three weeks for continued care. The facility social worker informed my mother on Monday, March 1, 2010 that her health carrier is not paying for care after Thursday March 6. Today, March 2, I spoke with the director of Physical Therapy, who confirmed that my mother was making good progress, that she needs more therapy and there was no medical reason to discharge her.
I called HIP and they want a Dr.authorization/recommendation/prescription for additional in-patient rehab by the Primary Care Physician. Meadowbrook does not permit a patient's primary care Doctor to set foot in the facility and does not release progress notes. The Meadow brook medical staff never indicated to my mother or family members that in-patient rehab should be terminated or could be done out-patient. In fact they made it sound like HIP will not pay, when in fact, the facility staff is the barrier to continued therapy.
My mother was forced to sign a paper agreeing to personally pay exorbitant rates after Thursday. She does not suffer from any other difficulties other than she cannot get out of bed or walk. She has no heart, lung, kidney, hearing or sight problems. She does not suffer from dementia, diabetes, high blood pressure or high cholesterol. She survived colon cancer and tolerated chemo therapy very well. Prior to the back compression fracture, she drove, shopped, volunteered as a tutor, at a soup kitchen, visited the home bound and administered communion. She enjoys many friends, plays cards, gardens.
I am aware of two other patients who were 'thrown' out of Meadow brook with similar situations--needing more care and being told insurance won't pay. I suspect that Meadowbrook receives more money from admitting new patients (collecting payments for new patient assessments) than continuing needed care for patients. I am unsure of the relationship of the Dr. who staff the facility and their proprietary interest in the Meadowbrook Care Center Corporation. There is a final appeal process. Whatever the appeal company, I-Pro, says is final and un-appealable. Is there a conflict of interest for Drs, if there is a profit motive for Drs to cease authorizing continued treatment in favor of filling the facility with new patients?
My mother, Petra, is a resident of a Nursing home in Florida (Ocala Health and Rehab Center). I live in NY and would like for her to reside in a facility closer to my home. I contacted Meadowbrook Care Center and explained the situation to them. I made them fully aware that my mother suffers from Alzheimer's Disease and has the propensity to wander. They told me they could accomodate her and that they have a "lock-up" unit for people who wander.
I went to see the facility, where a woman by the name of Kathy, took me to the "lock-up" unit where my mother would be placed. She explained that my mother could be accomodated there, and I saw for myself that was the fact. I gave them all the details and history about my mother including her medical condidition of Alzheimer's Disease and she assured me they could take her in.
She informed me that I needed a P.R.I. for my mother to be admitted. They insisted this was the law and that I needed the P.R.I from a NY certified Nurse. They informed me that I could not get the P.R.I. from the nursing home where she currently resides and they gave you the number of a private agency to get this done. The P.R.I. cost me $175.00 and it was a mandatory requirement. Once the P.R.I. was complete and reviewed by Meadowbrook Care Center, they informed me that they had rejected my mother's application. The excuse they gave was that she had Alzheimer's and they did not have the facilities to care for her.
Meadowbrook Care Center was fully aware, before insisting I purchase a P.R.I., of my mother's Alzheimer's. They showed me in person the faciliy they would keep her in and assured me they were capable and equipt for this type of patient care. In conclusion, if they knew they could not support Alzheimer's patients, and they knew my mother had the disease, then I didn't neeed a P.R.I but they forced me to purchase one anyway. Also, they showed me in person the "lock-up" unit they would keep her in and told me they were equipt to handle her.
