Requires the commissioner of health, in conjunction with the superintendent of financial services, to promulgate rules and regulations requiring that any increase in a bill from a hospital or health system or health care provider shall be sent to a patient no later than ninety days after the original bill was paid in full by such patient and good cause be shown for such increase, unless such increase is the result of any action by such patient.
STATE OF NEW YORK
January 10, 2022
Introduced by M. of A. GUNTHER -- read once and referred to the Commit-
tee on Health
AN ACT to amend the public health law, in relation to requiring the
commissioner of health to promulgate rules and regulations related to
the timeframe for increases to patients' bills
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 206 of the public health law is amended by adding a
2 new subdivision 32 to read as follows:
3 32. (a) The commissioner shall, in conjunction with the superintendent
4 of financial services, promulgate rules and regulations providing that
5 no patient shall be held responsible for any amounts for which a patient
6 would otherwise be liable as a result of an increase in any bill from a
7 health insurance company, hospital or health system or health care
8 provider after the date on which all amounts due under the original bill
9 were paid in full unless the health insurance company, hospital or
10 health system or health care provider, as applicable, can show good
11 cause for such increase and sends notice of such increase to the patient
12 no later than ninety days after the amount due by the patient in the
13 original bill was paid in full. No health insurance company, hospital
14 or health system or health care provider may send notice to a patient of
15 any increase in a bill unless such health insurance company, hospital or
16 health system or health care provider sends such notice prior to the
17 expiration of such ninety day period and can show the good cause reason
18 for such increase. The foregoing restrictions in this subdivision shall
19 not apply to an increase which is the result of an action by such
20 patient warranting such increase.
21 (b) For purposes of this subdivision:
22 (i) "patient" shall mean the individual receiving medical services or
23 the individual responsible for paying the bill on behalf of the individ-
24 ual receiving medical services; and
25 (ii) "good cause" shall mean a clerical error, typographical error,
26 scrivener's error or computer error, unless a pattern of such errors
27 exists, fraudulent billing is alleged, or such error is due to gross
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 is old law to be omitted.
A. 8676 2
1 negligence, recklessness, willful malfeasance or other action taken
2 which is not in good faith.
3 (c) This subdivision shall not apply to health care services, includ-
4 ing emergency services, where physician fees are subject to schedules or
5 other monetary limitations under any other law, including the workers'
6 compensation law and article fifty-one of the insurance law, and shall
7 not preempt any such law.
8 (d) The rules and regulations required by this subdivision shall
9 include, at a minimum:
10 (i) a requirement that an explanation for any increase in a patient's
11 bill shall be provided in plain language in conspicuous twelve-point
12 bold face type and shall be available in the top six languages spoken in
13 the hospital's service area; and
14 (ii) a process to determine responsibility for amounts for which a
15 patient is not responsible by reason of this subdivision.
16 § 2. This act shall take effect immediately.