May 6, 2014
New York, NY – Back in the early part of the 1970s, when New York County Health Services Review Organization (NYCHSRO), the progenitor of what would later give rise to MedReview, got its start, CEO Joe Stamm didn’t think that a peer review organization intent on scrutinizing hospital billing and potential overcharges would ever really last.
“I thought that after a couple of years of this type of scenario, the hospitals would, in fact, recognize what our role is, and we would be out of business,” the NYCHSRO/MedReview CEO says.
Stamm reasoned that once those medical institutions realized they were being carefully monitored, they would “clean up their act.”
“But that hasn’t changed,” Stamm says.
Instead, 40 years and well over a reported $1 billion in post-appeal savings later, NYCHSRO and its for-profit offshoot MedReview, are still identifying cases where services are provided which are not medically necessary or where improper billing codes are used which increase provider reimbursements.
“I am not anti-provider,” Stamm says. “I think the hospitals should be given appropriate reimbursement – and timely reimbursement. On the other hand, there are finite resources. And it is our job to make certain that the services rendered are medically necessary.”
Numerous city and state agencies, labor organizations and health plans, including the New York City Department of Health, New York City Office of Labor Relations, NYC Municipal Labor Committee, 1199 National Benefit Fund, United Health, MetroPlus and others rely on NYCHSRO/MedReview’s Health Utilization Management services to help keep their costs down.
What began as a strictly Manhattan-based review operation in 1974, has since grown to include 14 states around the country – as well as all the hospitals within New York.
“There are finite resources and those finite resources need to be stretched,” Stamm reemphasizes. “I see our job as stretching those finite dollars in order to make certain that there are enough dollars to go around for healthcare services.”
On May 7, NYCHSRO/MedReview will be honored inside the United States Capitol as part of the 2014 celebration of Jewish American Heritage Month.
“As MedReview continues to celebrate 40 years of service as an independent review-like organization, improving the world of healthcare through medical reviews, quality audits, and health services management you uphold the highest standards in the medical professional industry,” the American Jewish Heritage Month Foundation wrote.
Looking back on his 37 years with the organization, Stamm says that he is particularly pleased that NYCHSRO/MedReview took the time to engage in a variety of philanthropic efforts, including helping to aid earthquake victims in Haiti, actively working to support needy children in the Philippines and offering support to ordinary citizens under bombardment in Israel.
“I don’t just see us as an organization that does reviews for the sake of being paid,” Stamm says. “I look at it this way: Somebody has to speak up for the less fortunate because that doesn’t always happen.”