December 19, 2016
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Using New York State Consumer Protections to Get Insurers to Pay Bills

The election has created change and uncertainty around national health care laws, making now a good time for New Yorkers to understand state-based laws that protect us as health care consumers. New York State law contains consumer protections that can help individuals have care paid for by their insurer, avoiding large unreimbursed bills incurred by providers. Demystifying these legal rights can save insureds — and their advocates — time, money, and frustration, allowing them to focus on their health, instead of the cost of health care.

New Yorkers who get their private health insurance from a plan that is covered by New York law, whether that plan comes from an employer or the Marketplace, have four crucial consumer protections:

  • Transitional care laws allow individuals to continue receiving insurance coverage for seeing their doctor, even if that doctor is no longer covered by their insurance;
  • Appealing denials of care and payment from insurance companies;
  • Network adequacy protections requiring insurers to have enough providers of different types for their enrollees to access;
  • Surprise Bill law protecting consumers from paying certain out-of-network bills.

Our associate, Alex Berke’s recently published article in the New York State Bar Association Health Law Journal, “Using Health Insurance Consumer Protections To Increase Reimbursements For Providers and Decrease Out-of-Pocket Costs For Consumers,” examines these laws in depth, including how using them wisely can get a bill paid.

Changes are undoubtedly coming for the health insurance market, but not all relevant laws are Federal, and as New Yorkers, we should use the consumer protections we have to get the best value for our health insurance dollars.

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Berke-Weiss Law Weekly Roundup

July 6, 2020
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Here in New York, the governors of the tri-state area have formalized a quarantine for visitors from the hardest hit states while also mooting any chance of indoor dining in the foreseeable future, which mounting research indicates is a significant source of potential infectio

The Week in FFCRA Complaints

July 1, 2020
Pregnancy Discrimination
Paid Family Leave
Overall, we are beginning to see some patterns in the thematic nature of the complaints. Specifically, plaintiffs seem to be those whose employment has been terminated either after expressing concerns about workplace health and safety (e.g. improper distancing, lack of PPE, and not enforcing CDC-recommended quarantine procedures) and parents whose employment has been terminated because they were unable to locate appropriate childcare or family care.

What Employees Should Know About Their Rights to Protest, in Person or on Social Media

June 29, 2020
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Employees may find themselves retaliated against because of their protesting outside of the workplace, in person or online. But, as the protests continue, and the depth of feeling about their purpose grows, there will be increasing interest in using all available legal tools to allow employees to express their political views off-site while remaining employed.

Get In Touch

Knowing where to turn in legal matters can make a big difference. Contact our employment lawyers to determine if we can help you.