New York “Surprise Bill” Law Requires Out-Of-Network Disclosure

Effective April 1, 2015, the “New York Emergency Medical Services and Surprise Bills” law requires that health care professionals must make consumers aware that they are being referred to an out-of-network health care professional, facility, or other health entity. To ensure consumers are aware that they are being referred to an out-of-network health care professional, and consistent with Cigna policy, a New York Patient Notice and Disclosure Form for Referral to a Non-participating Health Care Professional, Facility, or Vendor must be completed by the referring physician (and not delegated) each time a Cigna participant is referred to an out-of-network health care professional or facility, including ambulatory surgical centers, dialysis facilities, and freestanding laboratories.* Once completed, this disclosure form provides Cigna customers with the necessary information to make an informed decision regarding the use of in- or out-of-network health care professionals and safeguards them from incurring “surprise bills” for out-of-network services. Please note that under this New York law, the disclosure requirement also applies to non-participating health care professionals and facilities. As such, out-of-network health care professionals cannot pursue payment from patients for surprise out-of-network medical bills if the referring physician did not comply with the disclosure requirements.