N.Y. Public Health Law § 24: Disclosure

§ 24. Disclosure. 1. A health care professional, or a group practice

of health care professionals, a diagnostic and treatment center or a

health center defined under 42 U.S.C. § 254b on behalf of health care

professionals rendering services at the group practice, diagnostic and

treatment center or health center, shall disclose to patients or

prospective patients in writing or through an internet website the

health care plans in which the health care professional, group practice,

diagnostic and treatment center or health center, is a participating

provider and the hospitals with which the health care professional is

affiliated prior to the provision of non-emergency services and verbally

at the time an appointment is scheduled.

2. If a health care professional, or a group practice of health care

professionals, a diagnostic and treatment center or a health center

defined under 42 U.S.C. § 254b on behalf of health care professionals

rendering services at the group practice, diagnostic and treatment

center or health center, does not participate in the network of a

patient's or prospective patient's health care plan, the health care

professional, group practice, diagnostic and treatment center or health

center, shall: (a) prior to the provision of non-emergency services,

inform a patient or prospective patient that the amount or estimated

amount the health care professional will bill the patient for health

care services is available upon request; and (b) upon receipt of a

request from a patient or prospective patient, disclose to the patient

or prospective patient in writing the amount or estimated amount or,

with respect to a health center, a schedule of fees provided under 42

U.S.C. § 254b(k)(3)(G)(i), that the health care professional, group

practice, diagnostic and treatment center or health center, will bill

the patient or prospective patient for health care services provided or

anticipated to be provided to the patient or prospective patient absent

unforeseen medical circumstances that may arise when the health care

services are provided.

3. A health care professional who is a physician shall provide a

patient or prospective patient with the name, practice name, mailing

address, and telephone number of any health care provider scheduled to

perform anesthesiology, laboratory, pathology, radiology or assistant

surgeon services in connection with care to be provided in the

physician's office for the patient or coordinated or referred by the

physician for the patient at the time of referral to or coordination of

services with such provider.

4. A health care professional who is a physician shall, for a

patient's scheduled hospital admission or scheduled outpatient hospital

services, provide a patient and the hospital with the name, practice

name, mailing address and telephone number of any other physician whose

services will be arranged by the physician and are scheduled at the time

of the pre-admission testing, registration or admission at the time

non-emergency services are scheduled; and information as to how to

determine the healthcare plans in which the physician participates.

5. A hospital shall establish, update and make public through posting

on the hospital's website, to the extent required by federal guidelines,

a list of the hospital's standard charges for items and services

provided by the hospital, including for diagnosis-related groups

established under section 1886(d)(4) of the federal social security act.

6. A hospital shall post on the hospital's website: (a) the health

care plans in which the hospital is a participating provider; (b) a

statement that (i) physician services provided in the hospital are not

included in the hospital's charges; (ii) physicians who provide services

in the hospital may or may not participate with the same health care

plans as the hospital, and; (iii) the prospective patient should check

with the physician arranging for the hospital services to determine the

health care plans in which the physician participates; (c) as

applicable, the name, mailing address and telephone number of the

physician groups that the hospital has contracted with to provide

services including anesthesiology, pathology or radiology, and

instructions how to contact these groups to determine the health care

plan participation of the physicians in these groups; and (d) as

applicable, the name, mailing address, and telephone number of

physicians employed by the hospital and whose services may be provided

at the hospital, and the health care plans in which they participate.

7. In registration or admission materials provided in advance of

non-emergency hospital services, a hospital shall: (a) advise the

patient or prospective patient to check with the physician arranging the

hospital services to determine: (i) the name, practice name, mailing

address and telephone number of any other physician whose services will

be arranged by the physician; and (ii) whether the services of

physicians who are employed or contracted by the hospital to provide

services including anesthesiology, pathology and/or radiology are

reasonably anticipated to be provided to the patient; and (b) provide

patients or prospective patients with information as to how to timely

determine the health care plans participated in by physicians who are

reasonably anticipated to provide services to the patient at the

hospital, as determined by the physician arranging the patient's

hospital services, and who are employees of the hospital or contracted

by the hospital to provide services including anesthesiology, radiology

and/or pathology.

8. A health care professional, or a group practice of health care

professionals, a diagnostic and treatment center or a health center

defined under 42 U.S.C. § 254b on behalf of health care professionals

rendering services at the group practice, diagnostic and treatment

center or health center, and a hospital shall make publicly available,

and if applicable, post on their public websites, and provide to

individuals who are enrollees of health care plans, a one-page written

notice, in clear and understandable language, containing information on

the requirements and prohibitions under 42 U.S.C. §§ 300gg-131 and

300gg-132 and article six of the financial services law relating to

prohibitions on balance billing for emergency services and surprise

bills, and information on contacting appropriate state and federal

agencies if an individual believes a health care provider has violated

any requirement described in 42 U.S.C. §§ 300gg-131 and 300gg-132 or

article six of the financial services law.

9. For purposes of this section:

(a) "Health care plan" means a health insurer including an insurer

licensed to write accident and health insurance subject to article

thirty-two of the insurance law; a corporation organized pursuant to

article forty-three of the insurance law; a municipal cooperative health

benefit plan certified pursuant to article forty-seven of the insurance

law; a health maintenance organization certified pursuant to article

forty-four of this chapter; a student health plan established or

maintained pursuant to section one thousand one hundred twenty-four of

the insurance law or a self-funded employee welfare benefit plan.

(b) "Health care professional" means an appropriately licensed,

registered or certified health care professional pursuant to title eight

of the education law.

(c) "Hospital" means a general hospital as defined in subdivision ten

of section two thousand eight hundred one of this chapter.