New York Billing Rights

Additional State-Law Protections for Patients with State-Regulated Health Plans

• For emergency services: If your insurance ID card says “fully insured coverage,” you can’t give written consent and give up your protections not to be balance billed for post-stabilization services.
• For non-emergency services: If your insurance ID card says “fully insured coverage,” you can’t give up your protections for services at in-network facilities if they are a surprise bill. Surprise bills under New York law are when you’re at an in-network hospital or ambulatory surgical facility and a participating doctor was not available, a non-participating doctor provided services without your knowledge, or unforeseen medical services were provided.
• For services referred by your in-network doctor: If your insurance ID card says “fully insured coverage,” surprise bills include when your in-network doctor refers you to an out-of-network provider without your consent (including lab and pathology services). These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. You may need to sign a form (available on the Department of Financial Services’ at www.dfs.ny.gov/system/files/documents/2022/01/Surprise_Medical_Bill_Certification_Form_2022.pdf) for the full balance billing protection to apply.

Filing a Complaint

If you think you’ve been wrongly billed and your coverage is subject to New York law (“fully insured coverage”), contact the New York State Department of Financial Services at 800-342-3736 or surprisemedicalbills@dfs.ny.gov.

State Agency Contact Information

New York State Department of Financial Services

Phone: 800-342-3736
Website: www.dfs.ny.gov

Additional Information

Visit www.dfs.ny.gov for information about your rights under state law.

Visit www.cms.gov/nosurprises/consumers or call 800-985-3059 for self-funded coverage or coverage bought outside New York or for more information about your rights under federal law.