“Emergency Medical Services and Surprise Bills” Law Takes Effect in New York

The “Emergency Medical Services and Surprise Bills” law, effective March 31, 2015, impacts billing and reimbursement for some out-of-network healthcare services.  The law firm of Kaufman Borgeest and Ryan, LLP, recently provided its clients with a summary of the key provisions of the law that affect physicians and other healthcare professionals. The firm has generously offered to share its update with readers of MLMIC’s blog.

Here’s a preview:

Providers in New York State who are out-of-network with any of their patients’ insurance plans (or refer patients to out-of-network providers) should immediately review their billing practices for compliance with the state’s new Emergency Medical Services and Surprise Bills law.  It subjects every NY licensed health care provider – physicians, physical therapists, hospitals, ambulatory surgery centers, home care agencies, etc. – to rules that:

  • may reduce the amounts providers bill out-of-network patients,
  • impose substantial new disclosure requirements regarding health plan coverage and patient fees, and
  • set up a new dispute resolution process to resolve billing disputes between providers and health plans.

Click here to view the PDF of the client advisory from Kaufman Borgeest and Ryan, LLP.