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2015 NYS Law Gives Protection from Surprise Bills and Emergency Services

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Posted: 03 Dec, 2015
by Valerie Bogart (New York Legal Assistance Group)
Updated: 24 Apr, 2019
by Peter Travitsky (New York Legal Assistance Group)

A new New York State law went into effect March 31, 2015 that protects consumers from "surprise bills" when services are performed by a non-participating (out-of-network) doctor at a participating hospital or ambulatory surgical center in your HMO or insurer's network or when a participating doctor refers an insured to a non-participating provider. The new law also protects all consumers from bills for emergency services.

The law is called  Surprise Bills for Health Care Services Law and can be found in the New York Financial Services Law Article 6 and NY Insurance Law Section 3241(c)

Here is a link to the Health Insurance Resource Center of the NYS Dept. of Financial Services, which thoroughly explains this new law-- https://www.dfs.ny.gov/consumers/health_insurance/surprise_medical_bills.  It explains what you need to know about these important new protections if:

  1. you have coverage with an HMO or insurer subject to New York law;
  2. you are uninsured or your employer or union provides self-insured coverage that is not subject to New York law; or
  3. you are a health care provider.

The article also describes the 

The Independent Dispute Resolution (IDR) Process  (Financial Services Law Article 6) and provides a link to the portal to  file a claim. 

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