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Protection from Surprise Bills and Emergency Services

Health Insurance Resource Center

A new law goes into effect March 31, 2015 that protects consumers from surprise bills when services are performed by a non-participating (out-of-network) doctor at a participating hospital or ambulatory surgical center in your HMO or insurer's network or when a participating doctor refers an insured to a non-participating provider. The new law also protects all consumers from bills for emergency services.

The following information explains what you need to know about these important new protections if: (1) you have coverage with an HMO or insurer subject to New York law; (2) you are uninsured or your employer or union provides self-insured coverage that is not subject to New York law; or (3) you are a health care provider.

Surprise Bills for Health Care Services
(Financial Services Law Article 6)

What You Need to Know To Protect Yourself From Surprise Bills If You Have HMO or Insurance Coverage Subject to NY Law (coverage that is not self-insured)   --> view info

What You Need to Know to Protect Yourself From Surprise Bills If You Are Uninsured Or If Your Employer or Union Provides Self-Insured Coverage (that is not subject to New York law)   --> view info

What You Need to Know About Surprise Bills If You Are A Health Care Provider   --> view info

Emergency Services
(Insurance Law Section 3241(c) and Financial Services Law Article 6)

The Independent Dispute Resolution (IDR) Process
(Financial Services Law Article 6)

Submit a Dispute Through the Independent Dispute Resolution (IDR) Process for Surprise Bills or Emergency Services

Review of Surprise Bills and Bills for Emergency Services by an Independent Dispute Resolution Entity (IDRE)

Payment for Independent Dispute Resolution (IDR)

Questions About IDR

If you have questions or need help completing an application, call (800) 342-3736 or e-mail

Updated 02/18/2016


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