12/02/2016

Notice from the NY Department of Health

The NY Department of Health and the NY Department of Financial Services recently sent a co-branded letter to health care providers about rules related to billing for patient co-payment or co-insurance.

As a reminder, providers are required to charge all patients the same price for the same services, excepting some occasional waiving of the co-payment for indigent patients and in instances where collection efforts are not cost effective. Routinely waiving a co-payment or a co-insurance may be considered insurance fraud.  Billing a patient’s insurer for a waived co-payment or co-insurance may also be considered insurance fraud.

Any provider who is determined to have engaged in fraudulent activity is subject to professional misconduct penalties, including revocation of their medical license. All providers are encouraged to review their current policies and practices to ensure compliance with laws, regulations and rules.