October 20, 2015
By Tara Jessup
New York, NY – Attorney General Eric T. Schneiderman has announced agreements with four urgent care centers to provide clear, detailed information to consumers about the centers’ participation with health plans. This move, the first enforcement action of New York’s recently adopted ‘Surprise Bill Law,’ will protect consumers from unexpected medical billings and help patients make informed choices when selecting a provider.
In July 2015, the Attorney General issued letters to 20 urgent care centers requesting information about the centers’ representations on websites that they participate in a certain health plan networks.
The Attorney General was concerned that these centers’ website disclosures might have inaccurately disclosed their health plan network participation status. As a result, consumers could receive unexpected bills from urgent care centers, when they believed that they would be responsible solely for their in-network co-payment or co-insurance obligation. New York’s “Surprise Bill Law,” which became effective March 31, 2015, requires, in part, that providers disclose in writing or through a website the health care plans in which the provider participates.
In addition, fee information must be made available to consumers. “At a time when many New Yorkers are feeling squeezed by rising health care costs, consumers deserve to know whether a provider is in-network or out-of network so that they know the costs before they choose a medical provider,” said Attorney General Schneiderman. “I commend the pledge by these urgent care centers to adopt critical reforms.”The Attorney General agreements require each center to strengthen disclosures and increase the instances of notification, including: On its website, identify all health plans with which it has contracted to be an in-network participating provider. If the center does not participate with all products that the health plan offers, it shall identify with specificity those insurance products for which it is an in-network, participating provider.