Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; provides such services must be covered if the insured person does not receive notification prior to such services or procedure.
Summary
Bill S04012 amends the New York insurance law to require that insured individuals receive prior notification when an out-of-network physician may be involved in their medical procedures, tests, or surgeries. This notification must come from the billing entity and inform the insured that the services of an out-of-network physician will not be covered by their insurance policy. Furthermore, if the insured does not receive this notification before the service is rendered, their insurance policy will cover the costs associated with the out-of-network physician's services.
Impact
The bill impacts state insurance laws by mandating clearer communication between billing entities and insured individuals regarding the use of out-of-network physicians. It aims to protect consumers from unexpected medical bills by ensuring they are informed about potential out-of-network charges before receiving care. This could lead to changes in how insurance companies and healthcare providers manage notifications and billing processes, potentially increasing transparency in healthcare costs.
Sentiment
The sentiment surrounding Bill S04012 appears to be supportive, as it addresses a common concern among consumers regarding unexpected medical expenses due to out-of-network services. Discussions indicate a recognition of the need for better communication in the healthcare system, although specific voting history and committee discussions are not available to gauge the level of bipartisan support or opposition.
Contention
Notable points of contention may arise from healthcare providers and insurance companies regarding the implementation of the notification requirement. Some stakeholders may argue that the bill could lead to increased administrative burdens or that it may not fully address the complexities of out-of-network billing. However, specific opposing views or concerns from particular parties are not documented in the provided context.
Same As
Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; provides such services must be covered if the insured person does not receive notification prior to such services or procedure.
Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; such services must be covered if the insured person does not receive notification prior to such services or procedure.
Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; provides such services must be covered if the insured person does not receive notification prior to such services or procedure.
An Act Requiring Health Insurers To Allow A Covered Person To Terminate Coverage And Procure Alternate Health Insurance Without Penalty When Such Covered Person's Health Care Providers Are Designated Out-of-network.
Addresses non-covered dental services by requiring all policies providing coverage of and all contracts for dental services issued to include a disclosure stating that a participating provider may charge their normal fee for services that are not covered; requires a cost estimate to be provided.
Addresses non-covered dental services by requiring all policies providing coverage of and all contracts for dental services issued to include a disclosure stating that a participating provider may charge their normal fee for services that are not covered; requires a cost estimate to be provided.
Requires that every insurer providing health coverage insurance provide every physician or physician group with a complete fee schedule seeing for the maximum allowable reimbursement for each covered service.