New York doctors, hospitals see a onetime critic become an ally

Physicians are grateful to receive support from a banker who formerly believed that those providing the care were the problem in health care finance.

By Jonathan G. Bethely, AMNews staff. Dec. 18, 2006.

When New York banker William Mooney first got involved with issues of health care finance, he figured any problems likely were caused by physicians and hospitals who didn't know how to run a business efficiently. But once he looked a little closer, Mooney had a change of heart and has become one of physicians' staunchest allies in fighting the conduct of what he now sees as the true problem: health plans.

Physicians and hospital associations credit Mooney and his organization, the Westchester County Assn., with providing the extra push that helped them get health plan reform in New York.

"He has helped reshape the provider side of the debate," said Moe Auster, council for the division of governmental affairs with the Medical Society of the State of New York. "He has helped move the business community on the side of providers on a lot of health care disputes [and] his efforts were helpful in getting legislation passed. What he does is supplement the efforts that the medical society has been taking."

Among the changes for 2007 mandated by the New York Legislature: requiring that commercial insurers standardize their coding requirements; shortening the credentialing period for new physicians from nine months to 90 days; and only allowing retroactive audits to go back two years, a decrease from six years.

Andrew Kleinman, MD, a plastic surgeon in Westchester, N.Y., said having someone like Mooney condemn some of the unfair business practices that health plans engage in on a daily basis makes a difference. The Westchester County Assn., located just north of New York City, is a business advocacy group whose members include everyone from local heating contractors to locally based giants such as PepsiCo.