New York's "Emergency Medical Services and Surprise Bills" Law

On April 1, 2015, the “Emergency Medical Services and Surprise Bills” Law went into effect throughout New York.  Healthcare providers will be obligated to provide patients with their plan affiliations prior to the provision of non-emergency services, and verbally at the time of the appointment.

The “Emergency Medical Services and Surprise Bills” law includes greater transparency of out-of-network (OON) charges and network participation, as well as broader availability of a patient’s right to go OON if the insurance plan’s existing network is insufficient and also safeguards against “surprise bills” from OON physicians. Below are some of the key provisions in the new law. This legislation will:

1. Impact billing a reimbursement for some out-of-network healthcare services
2. Require new disclosures from providers regarding their plan participation status
3. Add new rules for health plans regarding their plan participation status
4. Add new rules for health plans regarding networks and reimbursement for out-of-network services.

It is critical for providers and health plans to create an action plan to ensure compliance with the requirements of this law. MedTrainer now has a course available to help you understand how the new law will affect your organization. To view a sample of the course sign up for a Free Trial today!

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