Requires out-of-network treatment disclosure within twenty-four hours of approval of certain surgical procedures.
Summary
Bill A06143 amends the public health law to require hospitals and licensed entities providing surgical care to notify patients if any part of their approved treatment will be rendered by an out-of-network provider. This notification must occur via telephone, email, or text at the time of approval, and must be confirmed by mail within twenty-four hours. If the notice is not provided at least forty-eight hours before the procedure, the hospital or entity is responsible for covering the costs as if the services were provided by an in-network provider. Exceptions are made for surgical procedures performed within twenty-four hours of an injury.
Impact
The bill impacts state laws by enhancing patient protections regarding out-of-network surgical treatments. It establishes clear requirements for notification, thereby increasing transparency in healthcare billing practices. Hospitals and licensed entities will need to implement new processes to comply with these notification requirements, potentially affecting their operational procedures and financial responsibilities.
Sentiment
The sentiment around Bill A06143 appears to be generally supportive, as it aims to protect patients from unexpected medical bills associated with out-of-network providers. However, there may be concerns from healthcare providers regarding the administrative burden and financial implications of the bill's requirements.
Contention
Notable points of contention may arise from healthcare providers who could argue that the notification requirements impose excessive administrative burdens and could lead to increased costs for hospitals. Additionally, there may be concerns regarding the feasibility of providing timely notifications given the complexities of surgical approvals and insurance processes.
Requiring hospitals use a surgical smoke plume evacuation system and adopt policies for the evacuation of surgical smoke during certain surgical procedures.
Relates to not requiring a prior authorization determination for certain categories of cancer treatments based on National Comprehensive Cancer Network Guidelines.
Relates to not requiring a prior authorization determination for certain categories of cancer treatments based on National Comprehensive Cancer Network Guidelines.