New York Moves to Finalize Overhaul of Out-Of-Network Billing Dispute Process
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Crain’s New York Business [8/19] reports that the New York Department of Financial Services has moved “to finalize the controversial overhaul of a process that settles out-of-network payment disputes between doctors and insurers — a move that is reshaping how New York handles surprise medical bills.” Last week the department published guidance “governing independent dispute resolution, a process created in 2015 to protect patients from surprise bills. The state created protocols that allowed an independent arbitrator to decide how much a provider should be paid in out-of-network billing disputes, rather than a patient remaining liable for the balance of the bill.” In an interview with Crain’s, MSSNY Executive Vice President Dr. Thomas Lee said, “The big winners are Medicaid managed care companies.” As well as the Empire plan that covers state employees, he notes. Dr. Lee concludes, “The losers are the patients who need care.'”
