9/11 Health Watch Executive Director Benjamin Chevat said patients have already gotten letters from the Centers for Disease Control and Prevention's World Trade Center Health Program advising them to find other providers immediately, even if they have appointments on the books at MD Anderson's flagship hospital in Houston.
"Please be aware that the program will not cover any care you receive at [MD Anderson] going forward," the World Trade Center Health Program wrote in a notice to patients. "Our deepest apologies for this inconvenience." Advocates for 9/11 survivors and a World Trade Center Health Program spokesperson shared anonymized copies of these letters with Modern Healthcare.
9/11 Health Watch sent a letter Monday to MD Anderson President Dr. Peter Pisters, protesting the cancer center's stance on the program and the responders it covers.
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"As I understand MD Anderson's position, you are not willing to adhere to the WTC Program's reimbursement guidelines, which nearly every other major cancer center in the country has accepted. This includes Moffitt Cancer Care Center, Roswell Park Cancer Center, Memorial Sloan Kettering and even MD Anderson of Florida," Chevat wrote.
"Why does MD Anderson feel the need to charge more than Sloan Kettering? And why would you deny the heroes and survivors of 9/11 cancer care that they would receive if they live anywhere else but Texas?" Chevat wrote in the letter, which the organization also sent to Texas Republican Sens. John Cornyn and Ted Cruz.
MD Anderson would not comment on the status of these patients, but said it is prepared to keep collaborating with World Trade Center Health Program.
"Since 2012, the University of Texas MD Anderson Cancer Center has worked with the World Trade Center Health Program network to develop agreements to serve patients enrolled in its program," MD Anderson said in a statement. "There have been no changes to the institution’s approach, and we are prepared to work with the World Trade Center Health Program network to continue caring for these patients."
Although 9/11 responders and survivors are concentrated in the New York metropolitan area, thousands came from around the country to aid in rescue and recovery. Congress and President Barack Obama created the World Trade Center Health Program and its national provider network in 2010 to treat people injured or sickened as a result of their efforts in New York. More than 600 Texas residents are members of the program, and 36 are MD Anderson patients.
World Trade Center Health Program beneficiaries do not pay for care received at participating providers. MD Anderson does not belong to the program's network but has treated 9/11 responders under what are known as single-use agreements, which enable beneficiaries to obtain treatment from providers outside the network. The specific rates MD Anderson was getting for 9/11 cancer patients are not publicly available.
"There have been limited individual case agreements that have allowed for some members to receive care through this hospital," a World Trade Center Health Program spokesperson said in a statement. "We continue to be in contact with MD Anderson about the potential for joining the [national provider network] but have yet to reach an agreement about reimbursement rates. In the meantime, the program is working with our members in Texas, as well as in other parts of the country, to connect them to qualified providers who are part of the [national provider network]."
Hospitals in the World Trade Center Health Program network are reimbursed at rates set under a workers' compensation program for federal employees, which are generally higher than Medicare payments. According to 9/11 Health Watch, MD Anderson is instead seeking reimbursements equivalent to 85% of its self-reported costs.
NewYork-Presbyterian Hospital likewise accepted 9/11 responders under single-use agreements for years, but patient complaints about this cumbersome process and political pressure contributed to the New York hospital joining the World Trade Center Health Program network in 2022.
MD Anderson is accustomed to high government reimbursements. The cancer center is one of 11 that are exempt from the Medicare prospective payment system and are reimbursed based on costs, akin to how Medicare payment policy operated before prospective payment systems debuted in the 1980s. These cancer hospitals are paid about 40% above Medicare rates, the Government Accountability Office reported in 2015.
