The provision, unveiled by Gov. Andrew Cuomo, is meant to protect consumers from surprises in their medical bills. Oftentimes those “surprises” stem from care provided by a specialist, and one whom the patient learned was out-of-network only after the service or procedure was performed.
Under the new provision, if patients are stuck with a surprise bill, they will be responsible for the amount their co-pay would be if the physician were in-network. The out-of-network physician and the insurance company will then have to resolve the bill with baseball arbitration, where each side proposes a price and an arbitrator chooses one.
The provision will go into effect in one year.
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