New York Patient Billing Rights & Protections

Protection

Surprise Billing Protections

Emergency Medical Services & Surprise Bills Law — New York was the first state to pass comprehensive surprise billing legislation (2015). The law protects patients from balance billing for emergency services and surprise out-of-network bills at in-network facilities.

New York was a national pioneer in surprise billing protections, enacting its law in 2015.
Patients are held harmless from surprise out-of-network bills — they only pay their in-network cost-sharing amounts.
Applies to emergency services and non-emergency services at in-network facilities by out-of-network providers.
New York uses an Independent Dispute Resolution (IDR) process to resolve payment disputes between providers and insurers.
Protections apply to fully insured health plans regulated by New York State — self-funded employer plans may be subject to federal law instead.

What this means for you

If you receive a surprise out-of-network bill, you are not responsible for the balance beyond what you'd pay for in-network care. Contact your insurer and reference the Emergency Medical Services & Surprise Bills Law to dispute any balance bill.

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Assistance

Financial Assistance & Charity Care

Under NY Public Health Law § 2807-k (Charity Care), hospitals in New York must provide financial assistance to qualifying patients.

New York requires all hospitals to have financial assistance policies and to screen patients for eligibility before billing.
The Health Care Financial Assistance Law requires nonprofit hospitals to provide free care to patients below 200% FPL.
Patients between 200-300% FPL may qualify for discounted care.
Hospitals must provide financial assistance applications in the patient's preferred language.
Medical debt cannot be sent to collections until financial assistance screening is complete.

How to apply

Ask the hospital's billing department for a financial assistance application.
Gather proof of income (pay stubs, tax return, benefit letters).
Submit the application — you can often do this even after receiving a bill.
If denied, appeal the decision and contact your state insurance department.

Know Your Rights

Additional Patient Rights in New York

Beyond surprise billing and financial assistance, New York law provides these important protections.

Surprise Bill Consumer Assistance

Patients can call the DFS surprise bill hotline (800-342-3736) for help with unexpected medical bills.

External Appeals

New York law provides the right to an external appeal when your insurer denies coverage. Appeals are reviewed by independent medical experts at no cost to the patient.

Hospital Price Transparency

All New York hospitals must post their standard charges online, including negotiated rates with specific insurers.

Debt Protections

New York's Exempt Income Protection Act protects a portion of income and assets from medical debt collection. Hospitals must follow specific rules before pursuing legal action.

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