Nili Yolin on Out of Network Provider

New York Seeks to Add Greater Protections Against Surprise Bills

Last week, the New York State Department of Financial Services released a proposed amendment to the regulations promulgated under the state’s Emergency Medical Services and Surprise Bills law (the SBL), which adds additional...more

10/14/2019 / Amended Regulation , Consumer Protection Laws , Health Care Providers , Health Insurance , Medical Expenses , New Legislation , NYDFS , Out of Network Provider , Prior Express Consent , Proposed Regulation , State and Local Government , Surprise Medical Bills

New Jersey Regulates Out-Of-Network Billing

News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for out-of-network services in New Jersey. Known as the “Out-of-Network Consumer...more

8/31/2018 / Ambulatory Surgery Centers , Billing , Disclosure Requirements , Health Care Providers , Healthcare Facilities , Medical Reimbursement , New Legislation , Out of Network Provider

California Joins New York and Florida, Passes Out-Of-Network Legislation

Last month the California legislature passed AB-72, which amends the Health & Safety Code to address reimbursement for out of network (OON) providers who provide services at in-network facilities, such as hospitals and...more

9/19/2016 / Dispute Resolution , Health Care Providers , Out of Network Provider , Physicians , Reimbursements

After New York, Florida Curbs Surprise Bills for Emergency and Out-of-Network Services

It is generally understood that if a managed care member utilizes the services of a non-participating provider, the member could incur significant out of pocket expenses. However, there are instances where a member may...more

4/29/2016 / Billing , Dispute Resolution , Emergency Rooms , Hospitals , Managed Care Contracts , Out of Network Provider , Patient Rights , Reimbursements , Transparency

CMS Takes Action Against Network Transparency While New Jersey Legislation Hits a Snag

Just as the Centers for Medicare & Medicaid Services (CMS) began holding federal health care plans accountable for their provider network transparency obligations, the New Jersey legislature stalled in its bid to pass a law...more

2/10/2016 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Healthcare Costs , Medicare Advantage , Out of Network Provider , Qualified Health Plans , Transparency

How New York’s Emergency Medical Services and Surprise Bills Law Impacts Providers and Plans

Last year New York passed legislation known as the “Emergency Medical Services and Surprise Bills” law, a much-heralded consumer protection law primarily intended to guard against surprise bills for out of network (OON)...more

4/22/2015 / Disclosure Requirements , Health Care Providers , Health Insurance , Healthcare , Hospitals , Out of Network Provider , Physicians , Qualified Health Plans

New York’s Surprise Medical Bill Law Goes into Effect

New York’s Emergency Medical Services and Surprise Bills law went into effect yesterday, which means consumers who receive out of network (OON) emergency services will no longer have to pay more than their usual in-network...more

4/3/2015 / Emergency Rooms , Health Insurance , Healthcare , New Legislation , Out of Network Provider

New York Enacts Out-Of-Network Transparency and Coverage Reform

Last month, a woman sued a health plan, claiming that she was intentionally misled about which physicians were participating providers in the company’s online health insurance exchange established under the Affordable Care...more

7/9/2014 / Affordable Care Act , Healthcare , Out of Network Provider , Transparency

Nili Yolin

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