A New York law makes providers discuss health care costs with patients : Shots

Routines are familiar to most people. When checking in appointments with a doctor or other health care provider, patients usually fill out and sign a stack of documents containing forms containing versions of the statement.

Patients may often not feel comfortable making that financial commitment before they know what the claim will be. But they generally sign the form. Because the alternatives often don’t get the services they’re looking for.

As a result, consumers may be at risk of unexpected invoice liability and medical liability.

In New York, state officials, advocates, and healthcare provider communities are engaged in attracting policies around efforts to protect consumers. Patient advocates don’t want them to remain signed with blank check forms that are put in financial risk. Doctors, hospitals and other healthcare providers don’t want to disrupt the workflow of their practices and payment logistics, especially with cost discussions and documents, after the service is provided.

The efforts of state officials to find satisfactory compromises have so far been insufficient.

There is a in the center State Law It came into effect last fall and prohibited patients from requiring patients to sign such consent before they receive treatment and discuss costs.

Legal analysts described it as the country’s first such law. The group of doctors cried out a foul, saying they would raise payment issues and other serious logistical issues.

These concerns have discovered traction. Shortly before the law began, the state health department delayed its implementation indefinitely. Additionally, the 2026 budget proposed by the Democratic government of Cathy Hochul can return to requiring providers to agree to pay care before they can receive treatment. It also revealed that the consent requirement does not apply to emergency care.

However, important provisions of the new law remain. Physicians and other healthcare providers are obligated to discuss costs with patients before they are asked to sign a form that agrees to pay for services.

Discussions on price transparency

Some consider even the rest of the regulations to be an important step.

“Providers with a positive obligation to discuss treatment costs are unique,” said Gregory Mitchell, a partner in the Health and Life Science Practice Group at McDermottwill & Emery Law Firm, which specializes in managed care. Clients across the country are reaching out to law firms by asking questions.

Requiring providers to discuss costs with patients, whether services are provided or later, would pose a “significant burden,” he said. Physicians and other healthcare providers generally do not know any details about patient deductions, cost sharing, or other insurance coverage details until the claim is submitted to the health plan.

Medical services differ from refrigerators and other products that people buy, doctors say. If a patient has undergone colonoscopy and does not want to pay for it, “we cannot regain services,” said Jerome Cohen, a gastroenterologist and president of the New York State Medical Association, who represents the physician.

Regarding the proposed changes to the 2026 budget, Cohen said the Medical Association “respects the governor’s efforts to amend this problematic financial consent requirement.”

However, patient supporters are being pushed back. The current practice is “unfair and wrong,” says Elizabeth Benjamin, vice president of health initiatives at the New York Community Services Association, a nonprofit that has successfully pushed the passage of several medical debt-related laws in recent years. According to Benjamin, no patient will need to preemptively agree to pay whatever the provider charges.

In a written response to the question, Daniel de Souza, a spokesman for the New York Department of Health, said the proposed changes to the law would be justified ” given the burden of this requirement on both patients and health care providers.” De Souza did not respond to requests for clarification as to what those patient burdens are.

“It’s like signing your consent to be scammed.”

Helen Clim left the doctor’s office in New York City’s Bronx area several years ago and signed an open-ended form agreeing to pay for the services the doctor recommends.

It was the first time that Clim, a Medicare target, visited its primary care practices. When she told them she didn’t want to sign the form, she was told she wouldn’t serve her unless she did.

“I’m one of the annoying people who actually read the form,” said the retired bank project manager. “It’s like signing consent to be deceived.” She found another practice that didn’t ask her to sign a similar form.

There is medical debt protection for other consumers at the federal and state levels. Federation There’s no surprise In certain instances, providers restrict consumers from billing out-of-network services. You also need to give it to your provider Honest Cost Estimates For self-paying patients. Consumer Financial Protection Bureau has been released Final Rules In January, it would have removed medical debt from people’s credit reports, but the rules were implemented. It’s frozen By the Trump administration.

Some states Additionally, New York is taking steps to protect consumers with medical debt.

Benjamin said he would not address the patient’s potential unlimited financial liability simply by requesting an unspecified “discussion” about costs. Under the bill drafted by Benjamin’s organization, providers had to give patients a written, sincere estimate of the costs expected to be made to them before they were served, and patients were not liable for unlimited or unspecified costs beyond that estimate.

“Let’s be the first state to actually have fair engagement rules for both providers and patients in advance that you agree to be financially liable at that point,” Benjamin said.

However, so far, the measure has not been introduced in Albany with a focus on the governor’s budget proposal.

Providers are also waiting, as budget plans must move through the legislative process.

Another New York medical debt-related law, which came into effect in October, aims to use credit cards to pay for medical services. The Hochul administration has not proposed to change it. The law prohibits providers from requesting pre-authorization of credit cards or storing patient cards on files. Providers also need to notify patients of the risk of paying medical expenses with a credit card that may be insufficient in medical debt. Additionally, providers are not permitted to help patients complete credit card applications under the law.

The law aims to halt unfair claims practices and reduce medical debt for New Yorkers. Previous laws prohibit the credit reporting of all medical debts and prohibit hospitals from suing patients with incomes below 400% of the poverty level.

New York providers don’t like credit card laws either, but the pushbacks seen in the Payment Consent Act have not been generated.

In a statement, Brian Conway, a spokesman for the Greater New York Hospital Association, said, “It is important that hospitals do not oppose the overall goals of hospital financial support law reform, but rather oppose the operational burdens that some specific provisions create and patient disclosure overload.”

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