For Immediate Release
MSSNY Secures $17 Million Wrongfully Withheld from New York Physicians by Health Insurance Plans
Westbury, NY—September 3, 2025 – The Medical Society of the State of New York (MSSNY) announced today that since August 2021, its Payment and Practice Division has successfully intervened in over 2,300 physician consults, resulting in the recovery of more than $17 million wrongfully withheld from New York physicians from various health insurance plans.
This milestone underscores both the value of MSSNY’s advocacy for physicians and the alarming frequency of insurer malfeasance that forces physicians to fight for rightful reimbursement. Physicians across New York continue to face systemic barriers to payment, including:
- Failure to comply with federal law: Insurers have ignored legally binding Independent Dispute Resolution (IDR) determinations and failed to pay within the 30-day timeframe mandated by the federal No Surprises Act.
- Unlawful payment clawbacks: Carriers continue to take back funds years after claims were settled, despite New York State law prohibiting such practices.
- Unpaid claims with no accountability: One insurance plan has left more than 739,000 claims dating back to 2013 unpaid, with physicians unable to reach any representative.
- Credentialing failures: Physicians have been improperly dropped from networks, leaving practices unpaid for months while errors were corrected.
- Improper denials: Carriers have labeled services as “experimental” even when CMS does not classify the CPT codes as such.
“These recoveries are a testament to MSSNY’s persistence on behalf of our members,” said MSSNY President David Jakubowicz, MD. “But the reality is stark: physicians should not have to depend on MSSNY intervention to receive payments that are legally owed to them. Every dollar insurers delay or deny undermines the stability of physician practices and jeopardizes patient access to care. We are monitoring for further changes in the insurance marketplace including possible narrowing of networks by removing physicians from panels and we will respond accordingly to protect the interests of our members.”
MSSNY continues to work with state and federal regulators, legislators, and national medical organizations to demand enforcement of existing laws, penalties for noncompliance, and accountability from health plans. In addition, MSSNY has supported numerous legislative measures introduced in the New York State Legislature to address health insurer delays in approval for needed patient care, and to increase penalties on health insurers for violations of existing laws.
“Physicians care for patients in good faith every day,” Dr. Jakubowicz continued. “Insurers must be required to do the same when it comes to paying for that care.”
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Founded in 1807, the Medical Society of the State of New York is the state’s principal non-profit professional organization for physicians, residents, and medical students of all specialties. Its mission is to represent the interests of patients and physicians to assure quality healthcare services for all.
Media Contact:
Roseann Raia | Manager, Communications
Medical Society of the State of New York
865 Merrick Avenue
Westbury, NY 11590
516.488.6100 x302 | [email protected]
Julie Vecchione
Vice President, Communications
Medical Society of the State of New York
865 Merrick Avenue
Westbury, NY 11590
516.488.6100 x340 | [email protected]
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