From the Daily News:
Big insurance companies and some greedy doctors are to blame for the growing number of New Yorkers whacked with ”surprise” medical bills, a state inquiry has found.
Department of Financial Services Superintendent Benjamin Lawsky Wednesday released the results of his probe into the unanticipated bills that are slamming consumers.
"Simply put, surprise medical bills are causing some consumers to go broke," the report states.
His agency reviewed 2,000 complaints from 2011 and surveyed the 11 big insurers and HMOs who cover 95% of the New Yorkers who have health insurance.
The review found that patients who went out of their way to make sure the non-emergency treatment they sought was covered by their plan still wound up with bills from specialists — such as assistant surgeons, anesthesiologists and radiologists — who were outside their plan.
That’s because insurers often don’t make clear who will be involved and how much it will cost, the report found.
Also from the Daily News:
The fix here is pretty simple.
One, the Legislature must cap an individual patient’s responsibility for the cost of emergency care. A heart attack or late-stage cancer discovery should not bankrupt a family.
Two, nonemergency patients must be given reasonable notice if an out-of-network practitioner is scheduled on their case.
Three, the “small but significant number” of out-of-network doctors who the state says are inflating bills for treatment must feel the wrath of state watchdogs.
And — this is absolutely critical — insurance companies must be required to clearly disclose, up front, precisely what they will pay for out-of-network services so consumers can accurately compare health plans.