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NY Aims to Stop "Surprise" Out-of-Network Bills for Thousands

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Monday, March 24, 2014   

NEW YORK - It is happening all too often and driving some New Yorkers into bankruptcy, according to consumer advocates. The problem is "surprise" medical bills, and state lawmakers are being urged to act now.

Chuck Bell, programs director, Consumers Union, said far too many New Yorkers end up with a shocker in the mail, and all too often it is a bill for "out-of-network" medical expenses.

"Here in New York State each year, over 3,000 patients contact the state or their insurance company with complaints about a surprise bill. We in the consumer world think this is just-the tip of the iceberg," Bell said.

Advocates say after two years of trying, Gov. Cuomo's budget now includes legislation that would protect New Yorkers from out-of-network expenses that were beyond their control. Bell said it would also require more disclosure by providers and insurance companies.

New Yorker Claudia Knafo, a concert pianist, said when she had a medical procedure last year she made sure the doctor was listed as in-network, but then got a shocker of a bill, anyway.

"Surprise - a $97,000 out-of-network medical bill! I was in disbelief," Knafo said. "It wasn't an emergency, so it left me with some time to do the proper research. I just can't believe that I got caught in this quicksand."

The State Department of Financial Services cancelled the bill to Knafo and told the doctor and insurance company to settle. Heidi Siegfried, project director, New Yorkers for Accessible Health Coverage, said the new law would give all New Yorkers similar protections.

"Where there is not disclosure and you don't know that you're seeing out-of-network providers, the bill would be worked out between the insurance company and the provider, and the patient would have nothing whatsoever to do with it," Siegfried explained.

Benjamin Lawsky, New York Superintendent of Financial Services, will have a news briefing with advocates on the issue today at 10:15 a.m. in Albany.



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