Proposed measures address surprise medical billing in New York

It’s no secret that health insurance, medical care and medical billing are a circuitous mess in the United States. One particularly burdensome problem is that many patients are billed for medical care that isn’t covered by their insurance plans. Such care is called out-of-network care, and unfortunately patients don’t always know when they are receiving out-of-network services.

The result is surprise medical billing that in many cases presents an overwhelming burden that leads to bankruptcy.

Each year, people throughout New York receive unexpected, exorbitant medical bills. In fact, the New York Department of Financial Services reports that annually about 3,000 patients register complaints regarding surprise medical billing.

In many cases, patients are under the impression that they are being treated by an in-network provider, but an out-of-network specialist — an anesthesiologist, for instance — ends up providing some form of care. Time passes, and eventually the patient receives the surprise bill.

Additionally, when an emergency arises, patients may not have much of a choice about whether a necessary medical service is covered by the network.

The good news is that some consumer protections are being considered this year by New York legislators. The changes have been proposed by Gov. Andrew Cuomo, and they would do a number of things, such as establish better disclosure requirements regarding the cost of out-of-network care.

The proposed legislation would also require hospitals and clinics to tell patients when out-of-network care might be used in non-emergency treatment.

Medical debt alone can lead to bankruptcy, but heavy medical debt combined with other debts can be especially overwhelming. To assess your particular situation and establish a plan of action, it is a good idea to consult with a debt relief attorney.

Source: The Journal News, “New York needs law to protect against ‘surprise’ medical bills,” Charles Bell, March 24, 2014