No-Surprise Bills

The New York State Legislature recently enacted a consumer-protection law to prevent unexpected medical bills. The Emergency Medical Services and Surprise Bills law requires physicians, ambulatory practices and hospitals to:

  • Notify patients about which health plans they participate in
  • Share the names and contact information for all providers to be involved in the patient’s scheduled care, including those who are out of network

For scheduled services that are out of network, the new law requires providers to disclose a patient-cost estimate prior to providing nonemergency care. For emergency care, patients are required to pay only their in-network cost, regardless of whether the participating providers are enrolled in the patient’s health plan.

“North Shore-LIJ has a long-standing history of transparency with patients to minimize the occurrence of ‘surprise’ medical bills,” said Mark Solazzo, executive vice president and chief operating officer for the North Shore-LIJ Health System. “The introduction of this new law requires physicians, ambulatory practices and hospitals to refine certain processes and patient materials to ensure full compliance.”

For more details, see the Consumers Union summary at bit.ly/1ySKZPS. North Shore-LIJ offers online tools such as an out-of-pocket expense calculator, the FollowMyHealth patient portal, web payments and more at bit.ly/manageME.

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