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New York’s surprise billing law works. The nation can learn from it.

Financial Help for Patients in New York

On Tuesday, April 2, the U.S. House of Representatives’ Education and Labor Committee’s Subcommittee on Health, Employment, Labor and Pensions held a hearing entitled, “Examining surprise billing: Protecting patients from financial pain.”

This is just one hearing we expect this Congress will hold on the subject of surprise bills and pricing transparency.  The attention is understandable and well-placed. Transparency with regard to healthcare costs is important, and that’s why New York and its hospitals and health systems are already leaders in advancing productive transparency initiatives, including those that protect patients from unexpected “surprise bills.”

In an April 2 letter to Rep. Joseph Morelle (D-Irondequoit), who serves on the subcommittee and attended the hearing, HANYS President Bea Grause highlighted important reforms implemented in New York that help to protect New Yorkers from financial issues that have so often made headlines in other parts of the country in recent years.

“New York’s law has been in place for two years and has been used to settle about 2,000 billing disputes. Consumer advocates are happy with how the law has worked, as are the hospitals, and early economic research suggests that it’s working.” – Vox

Read HANYS’ guide to New York’s out-of-network consumer protection law to learn more about the state’s reforms.

HANYS’ price transparency principles

New York’s hospitals are committed to supporting consumers’ healthcare decision-making with education and information.

HANYS believes the following principles must guide any future policies and initiatives designed to protect consumers:

  • Hospital charges are not a good way to inform consumers about what prices they may pay.
  • Medicare and Medicaid should adequately reimburse providers for services to avoid the cost shift that drives up hospital charges.
  • Instead of broad-based charge or price transparency efforts, the industry should focus on protecting consumers from unexpected and unnecessary out-of-pocket health spending.
  • Insurers are the best source of pricing information for consumers with employer-based and other forms of private coverage.

As conversations regarding nationwide transparency policies advance, HANYS will continue to engage with federal policymakers to educate them on what’s worked in New York, what patients need and how the impacts of “surprise bills” can be lessened for all Americans.