Mount Kisco, N.Y. – (1/27/12) – Senator Greg Ball (R, C – Patterson) is leading the charge on legislation that would stop allowing insurance companies to use and abuse the citizens of New York.
Senator Ball’s bill (S5068/A5068A) requires health insurance companies to:
- Fully disclose their methodology for reimbursing health care treatment by physicians not participating in the plan’s network
- Prohibit approval of a health maintenance plan that does not include coverage of out-of-plan medical services
- Disapprove issuance of a health insurance policy offering coverage for out of network care that will not provide significant coverage of the usual costs of receiving care out of the plan’s network
- Require health insurance companies to disclose to their enrollees, upon request, the anticipated out-of-pocket costs for specific out-of-network health care services
“You have multi-billion dollar insurance companies that are seeing record profits, you have a healthcare system that is broken, you have doctors that are being forced out of this state in droves and it’s actually reaching a critical level,” Senator Ball said. “Meanwhile, you have blue-collar families that are being held over the barrel by insurance companies that are raking in billion-dollar profits.”
Maureen Kenney of Bedford Hills is just one of thousands of New Yorkers that have purchased premium insurance plans, only to be stuffed with the bill in their time of need.
In April of 2011, Kenney’s husband was treated in the ER at Northern Westchester Hospital, which is an “in network” hospital, for a heart condition. Although he was given the best of care at Northern Westchester Hospital, Kenney said their facility was not equipped to treat her husband’s life-threatening condition. Due to medical necessity, Kenney’s husband was transported by an ambulance to Westchester Medical Center (WMC). The transfer to WMC was arranged by the ER physician and the WMC cardiologist on duty via phone. Kenney said there was no mention in regard to concerns over insurance coverage, or that WMC was an “out of network” provider during the treatment or transfer. However, Kenney later received a $99,000 bill from WMC due to the fact that it is an “out of network” hospital.
“I think it’s happening to more people than we know who do not complain or try to fight it because the liability might be smaller and it is either paid by the policy holder, or they are too intimidated by the insurance companies,” says Kenney. “Our citizens should not be intimidated by insurance companies, who should be helping our citizens in times of need, not bleeding them for every dollar in a tough economy.
Dr. Thomas Lee said he is confident that this bill will fully remedy all of the problems that patients like Maureen have experienced.
“With the passage of this bill, the patients will hopefully continue to receive the healthcare benefits they have worked so hard to afford,” Dr. Lee said.
The Ball Bill has passed out of the Senate Health Committee. The bill will now go through the Insurance Committee and the Finance Committee before it is voted on in the full Senate.
“Anyone could find themselves in the same situation Maureen Kenney is now facing,” Senator Ball said. “I am urging everyone to tell their local elected officials to help us pass this critical piece of legislation and give New Yorkers the quality, affordable healthcare they deserve.”
For more information or to speak with Senator Ball, please contact Brittany Oat: (845) 200-9716.