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New Law Protects New Yorkers from Big Surprise Medical Bills

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Friday, April 3, 2015   

NEW YORK - New Yorkers can breathe a sigh of relief this month because they now have new protections from so-called surprise medical bills.

Many New Yorkers ended up with big bills for out-of-network care because of visits to the emergency room. Chuck Bell, programs director for Consumers Union, said a new law that took effect this month provides much-needed protections.

"Through this new law, our consumers in New York state will be able to avoid getting most surprise medical bills in the first place," he said, "and when they do get a surprise bill, this law will help them prevent protracted financial disputes."

On average, Bell said, about 2,000 New York consumers per year filed complaints about surprise medical bills.

Heidi Siegfried, project director for New Yorkers for Accessible Health Coverage, said the new law puts the responsibility on doctors and health networks to ensure that their network information is up to date, and protects consumers who may have relied on outdated information.

"The plan and the provider have to work out what the payment is going to be," she said, "and the patient does not have to pay anything other than the normal in-network charges if they are seeing an out-of-network provider and it wasn't their fault."

Bell said the law also protects New Yorkers from so-called drive-by doctors who were not in the initial game plan when patients underwent a procedure.

"A physician that you didn't expect sometimes shows up during the procedure, and afterwards you find you have a bill for visiting an out-of-network doctor," Bell said. "So the law provides for greatly expanded disclosure to consumers when out-of-network doctors are going to be involved in your care."

The new law also calls for an examination of health networks to make sure they actually provide all of the suitable care that New Yorkers need. If any network is found not to have a provider, New Yorkers will be able to go out of network without paying extra. Consumers still need to do their homework and see an in-network provider when they are available.


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