OMBUDSMAN ALERT: New York State Must Abolish All “Surprise” Medical Bills (Part II)

BY DR. LOUIS ALPERT

Ombudsman

Back on October 28, 2016 the Ombudsman Alert published an article calling upon our elected officials to improve the 2014 New York “Surprise Medical Bill Law,” which, while well-intended by our lawmakers, has not prevented many hospital and emergency room patients who were unable to find in-network treatment under their insurance program from receiving medical bills from an out-of network insurance company. These charges are often more than double the amount that would have been charged in their own in-network insurance program!

Although the original 2014 “Surprise Medical Bill Law” provided for a mechanism for the over-billed patient to appeal the higher charges, many of such patients (particularly senior citizens) were unable to successfully make such an appeal and ended up paying the higher amount upon threat of legal action from the medical bill collection agency assigned to their case.

In answer to the Ombudsman Alert’s October 28, 2016 appeal to our New York State legislators, New York Assemblypersons Ken Zebrowski and Ellen Jaffee submitted the following statements:

Assemblyman Ken Zebrowski: “We will take a look at the law and review ways to strengthen and improve it.We will be thoroughly looking at the law and speaking with our health and insurance committee staff to see what coukd be done to improve the law. The  Assemblyman is always looking for ways to provide patients with more transparency concerning their medical bills and hopefully  can build on the success of the 2014 law.”

AssemblywomanIn my recent Ellen Jaffee: “We would certainly consider adding an amendment to the current law to go a step further to protect vulnerable patients who receive life-saving hospital or emergency services from a out-of-network provider, ensuring that the only bill generated for these services will come from the patient’s in-network provider.”

When queried this week, Senator David Carlucci said, “New York is leaps and bounds ahead of the federal government when it comes to addressing surprise medical bills. In 2015, our law took effect, allowing patients who fall victim to these astronomical bills to get reimbursed by filling out a form and sending it to the insurance company. However, if insurance companies or patients are unaware of the law or the form, we must raise awareness and make it easier on the patient. I will certainly be looking into further legislation to address the issue.”

In my recent contacts with our two Assemblypersons as well as our New York State Senator David Carlucci I have requested that all three sponsor an amendment to the “Surprise Medical Bill Law” in both the New York Assembly and Senate to completely eliminate all surprise medical bills. The Ombudsman Alert requests all interested readers of this column to contact these three elected representatives, encouraging them to immediately file these critical amendments to these existing bills in the NY Assembly and Senate.

Please address all comments and questions to: [email protected]

  Ombudsman Alert, suprise medical bills