Insurers Are Required to Ensure Enrollees Do Not Incur Greater Out-of-Pocket Costs from Non-Participating Care Providers
Governor Cuomo: "With this new law, insurers will need to do the right thing and make sure patients aren't strapped with excessive and potentially debilitating out-of-pocket costs tomorrow simply because they needed emergency room care today."
Governor Andrew M. Cuomo today signed legislation (S.3171/A.264B) protecting patients from excessive out-of-network hospital emergency charges, including hospital inpatient services that follow an emergency room visit. The new law requires health insurance companies to ensure that when enrollees receive care from a non-participating provider, the patient will not incur greater out-of-pocket costs than they would have incurred from a participating provider.
"In an emergency, every second counts and its ridiculous to expect someone facing a potential life or death situation to first check and see if a hospital is part of their health insurance network," Governor Cuomo said. "With this new law, insurers will need to do the right thing and make sure patients aren't strapped with excessive and potentially debilitating out-of-pocket costs tomorrow simply because they needed emergency room care today."
The bill also requires that hospital charges for emergency services are subject to an independent dispute resolution process that was established by New York's Surprise Medical Bill law, originally enacted in 2014, which was the first of its kind in the nation to comprehensively protect consumers from surprise bills for out-of-network costs.
The law goes into effect immediately.
Senator Liz Krueger said, "When New Yorkers go to the hospital in an emergency, they can't be expected to make sure every procedure is delivered by an in-network provider. This new law will protect New York families from outrageous surprise medical bills and help keep overall medical costs down. I thank Assembly Member Cahill for carrying this bill in the Assembly, and Governor Cuomo for signing it today."
Assembly Member Kevin Cahill said, "Relieving consumers of the aggravation associated with billing disputes between health care providers and insurance companies is one step closer to completion. With Governor Cuomo's signature on our legislation today, New York reasserts its national leadership in protecting patients from surprise bills and providing a responsible means of holding down health care costs."