NY DFS Proposes “Surprise Bill” Amendment

On October 10, the New York State Department of Financial Services released a proposed amendment to the state’s Out-of-Network Law. If approved, the amendment would require insurance companies and healthcare providers to comply with several new requirements to better protect consumers from “surprise” medical bills.

Insurers that receive a claim for services rendered by a non-participating provider would be required to provide certain information to the insured consumer at the time an explanation of benefits is sent, including a notification that the consumer may receive a surprise bill and information on the Out-of-Network Law’s independent dispute-resolution process. Non-participating providers who bill a patient for emergency services or send a surprise bill would also be required to notify the consumer of the dispute process.