§ 24 — Disclosure

New York § 24

• Jurisdiction: New York
• Law PBH: Public Health
• Title 2: General Provisions
• Art. 1: Short Title and Definitions: General Provisions

Text

§ 24. Disclosure. 1. A health care professional, or a group practice\nof health care professionals, a diagnostic and treatment center or a\nhealth center defined under 42 U.S.C. § 254b on behalf of health care\nprofessionals rendering services at the group practice, diagnostic and\ntreatment center or health center, shall disclose to patients or\nprospective patients in writing or through an internet website the\nhealth care plans in which the health care professional, group practice,\ndiagnostic and treatment center or health center, is a participating\nprovider and the hospitals with which the health care professional is\naffiliated prior to the provision of non-emergency services and verbally\nat the time an appointment is scheduled.\n 2. If a health care professional, or a group practice of health care\nprofessionals, a diagnostic and treatment center or a health center\ndefined under 42 U.S.C. § 254b on behalf of health care professionals\nrendering services at the group practice, diagnostic and treatment\ncenter or health center, does not participate in the network of a\npatient's or prospective patient's health care plan, the health care\nprofessional, group practice, diagnostic and treatment center or health\ncenter, shall: (a) prior to the provision of non-emergency services,\ninform a patient or prospective patient that the amount or estimated\namount the health care professional will bill the patient for health\ncare services is available upon request; and (b) upon receipt of a\nrequest from a patient or prospective patient, disclose to the patient\nor prospective patient in writing the amount or estimated amount or,\nwith respect to a health center, a schedule of fees provided under 42\nU.S.C. § 254b(k)(3)(G)(i), that the health care professional, group\npractice, diagnostic and treatment center or health center, will bill\nthe patient or prospective patient for health care services provided or\nanticipated to be provided to the patient or prospective patient absent\nunforeseen medical circumstances that may arise when the health care\nservices are provided.\n 3. A health care professional who is a physician shall provide a\npatient or prospective patient with the name, practice name, mailing\naddress, and telephone number of any health care provider scheduled to\nperform anesthesiology, laboratory, pathology, radiology or assistant\nsurgeon services in connection with care to be provided in the\nphysician's office for the patient or coordinated or referred by the\nphysician for the patient at the time of referral to or coordination of\nservices with such provider.\n 4. A health care professional who is a physician shall, for a\npatient's scheduled hospital admission or scheduled outpatient hospital\nservices, provide a patient and the hospital with the name, practice\nname, mailing address and telephone number of any other physician whose\nservices will be arranged by the physician and are scheduled at the time\nof the pre-admission testing, registration or admission at the time\nnon-emergency services are scheduled; and information as to how to\ndetermine the healthcare plans in which the physician participates.\n 5. A hospital shall establish, update and make public through posting\non the hospital's website, to the extent required by federal guidelines,\na list of the hospital's standard charges for items and services\nprovided by the hospital, including for diagnosis-related groups\nestablished under section 1886(d)(4) of the federal social security act.\n 6. A hospital shall post on the hospital's website: (a) the health\ncare plans in which the hospital is a participating provider; (b) a\nstatement that (i) physician services provided in the hospital are not\nincluded in the hospital's charges; (ii) physicians who provide services\nin the hospital may or may not participate with the same health care\nplans as the hospital, and; (iii) the prospective patient should check\nwith the physician arranging for the hospital services to determine the\nhealth care plans in which the physician participates; (c) as\napplicable, the name, mailing address and telephone number of the\nphysician groups that the hospital has contracted with to provide\nservices including anesthesiology, pathology or radiology, and\ninstructions how to contact these groups to determine the health care\nplan participation of the physicians in these groups; and (d) as\napplicable, the name, mailing address, and telephone number of\nphysicians employed by the hospital and whose services may be provided\nat the hospital, and the health care plans in which they participate.\n 7. In registration or admission materials provided in advance of\nnon-emergency hospital services, a hospital shall: (a) advise the\npatient or prospective patient to check with the physician arranging the\nhospital services to determine: (i) the name, practice name, mailing\naddress and telephone number of any other physician whose services will\nbe arranged by the physician; and (ii) whether the services of\nphysicians who are employed or contracted by the hospital to provide\nservices including anesthesiology, pathology and/or radiology are\nreasonably anticipated to be provided to the patient; and (b) provide\npatients or prospective patients with information as to how to timely\ndetermine the health care plans participated in by physicians who are\nreasonably anticipated to provide services to the patient at the\nhospital, as determined by the physician arranging the patient's\nhospital services, and who are employees of the hospital or contracted\nby the hospital to provide services including anesthesiology, radiology\nand/or pathology.\n 8. A health care professional, or a group practice of health care\nprofessionals, a diagnostic and treatment center or a health center\ndefined under 42 U.S.C. § 254b on behalf of health care professionals\nrendering services at the group practice, diagnostic and treatment\ncenter or health center, and a hospital shall make publicly available,\nand if applicable, post on their public websites, and provide to\nindividuals who are enrollees of health care plans, a one-page written\nnotice, in clear and understandable language, containing information on\nthe requirements and prohibitions under 42 U.S.C. §§ 300gg-131 and\n300gg-132 and article six of the financial services law relating to\nprohibitions on balance billing for emergency services and surprise\nbills, and information on contacting appropriate state and federal\nagencies if an individual believes a health care provider has violated\nany requirement described in 42 U.S.C. §§ 300gg-131 and 300gg-132 or\narticle six of the financial services law.\n 9. For purposes of this section:\n (a) "Health care plan" means a health insurer including an insurer\nlicensed to write accident and health insurance subject to article\nthirty-two of the insurance law; a corporation organized pursuant to\narticle forty-three of the insurance law; a municipal cooperative health\nbenefit plan certified pursuant to article forty-seven of the insurance\nlaw; a health maintenance organization certified pursuant to article\nforty-four of this chapter; a student health plan established or\nmaintained pursuant to section one thousand one hundred twenty-four of\nthe insurance law or a self-funded employee welfare benefit plan.\n (b) "Health care professional" means an appropriately licensed,\nregistered or certified health care professional pursuant to title eight\nof the education law.\n (c) "Hospital" means a general hospital as defined in subdivision ten\nof section two thousand eight hundred one of this chapter.\n