Consumer Protections
Medical Billing Protections in New York
In addition to federal protections like the No Surprises Act, New York has its own consumer protection laws that may apply to your medical billing dispute. Here is an overview of the protections available to you.
Key Facts: New York Medical Billing Protections
Dispute Window
180 days from Explanation of Benefits (EOB) for insurance appeals
Applicable Statute
Consumer Protections
New York's Surprise Bills Law (2015) was one of the first comprehensive state surprise billing protections in the nation
Surprise Billing Protection
Yes — state-level surprise billing law
Balance Billing Restrictions
Yes — state restrictions on balance billing
Key Consumer Protections in New York
- New York's Surprise Bills Law (2015) was a pioneer in surprise billing protection.
- Patients cannot be balance billed for emergency services by out-of-network providers.
- Non-emergency services at in-network facilities by out-of-network providers are also protected.
- An Independent Dispute Resolution (IDR) process resolves payment disputes.
- Patients have the right to request an itemized bill from any healthcare provider.
- Patients can assign their rights to the provider to pursue the insurer directly.
- Consumers can file complaints with the New York Department of Financial Services.
Read the full statute: N.Y. Financial Services Law § 603 (Emergency Medical Services and Surprise Bills Law)
Disclaimer: This information is for general informational purposes only and does not constitute legal or professional advice. Laws and regulations may change. Consult a licensed attorney or certified medical billing advocate for advice specific to your situation.