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Protection for patients

New York Teacher

It’s easily among most people’s greatest fears: Having a medical emergency when you’re far from home, whether it’s an accident or a serious illness. Not being near friends and family is tough enough during a medical crisis; but you’re also being treated at a hospital emergency room that is not in your insurance plan’s network. It’s not unusual for the bill to come to tens of thousands of dollars for emergency services in an out-of-network hospital. You, as a consumer, have no right to question the billing — and if you are a public employee, your insurance company is obligated to pay the full bill, raising health care costs.

That’s why the UFT supports the Patient Protection Act  — New York Senate bill 3171-A/Assembly bill 264-A — that will protect patients from excessive hospital charges during ER visits. New York State law already protects patients from excessive charges when they visit an out-of-network physician in an emergency. In that situation, your insurance plan has the right to submit those charges for review to an independent dispute resolution entity that controls the charges.

The proposed bill is a common-sense companion to existing law and will ensure patients are not gouged when they require medical attention by any health care providers in an out-of-network hospital emergency room, or require services such as blood transfusions, IV fluids, burn treatment and other care. The patient — or the patient’s insurance company — will not be required to pay the hospital fees prior to submission of the bill to the dispute resolution process.

This proposal will save employee health plans tens of millions of dollars in costs that would inevitably be passed to consumers. The UFT is part of a diverse coalition supporting the bill that includes Empire and other insurance companies, Consumer Reports, the Business Council and AARP.

Health care should not force anyone into debt or bankruptcy. This bill will reduce the astronomical costs of out-of-network care while making our health insurance system more sustainable.

Related Topics: Health Benefits, Editorials