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NY Starts Out-Of-Network Health Coverage Protections

heaNew protections against big surprise medical bills are starting in New York.

They require insurance payments for out-of-network medical treatment in emergencies, when similar services or specialists are unavailable within the insurer’s network or when care is provided without the patient’s knowledge.

They don’t cover cases where consumers simply choose an outside physician or treatment over available network providers.

Mandated coverage begins Tuesday with newly issued or renewal policies.

The immediate requirement for doctors and hospitals is to update online or give written notice to patients about the insurance networks to which they belong.

Health maintenance organizations, or HMOs, already must authorize out-of-network coverage for emergency services, with patients required to pay only their usual network deductibles, copayments and coinsurance.

That requirement will now extend to other insurers as well.


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