2023 New York Laws › PBH - Public Health › Article 1 - Short Title and Definitions: General Provisions › Title 2 - General Provisions › 24 - Disclosure.

§  24.  Disclosure. 1. A health care professional, or a group practice
of health care professionals, a diagnostic and  treatment  center  or  a
health  center  defined  under 42 U.S.C. § 254b on behalf of health care
professionals rendering services at the group practice,  diagnostic  and
treatment  center  or  health  center,  shall  disclose  to  patients or
prospective patients in writing  or  through  an  internet  website  the
health care plans in which the health care professional, group practice,
diagnostic  and  treatment  center  or health center, is a participating
provider and the hospitals with which the health  care  professional  is
affiliated prior to the provision of non-emergency services and verbally
at the time an appointment is scheduled.
2.  If  a health care professional, or a group practice of health care
professionals, a diagnostic and treatment  center  or  a  health  center
defined  under  42  U.S.C. § 254b on behalf of health care professionals
rendering services at  the  group  practice,  diagnostic  and  treatment
center  or  health  center,  does  not  participate  in the network of a
patient's or prospective patient's health care  plan,  the  health  care
professional,  group practice, diagnostic and treatment center or health
center, shall: (a) prior to the  provision  of  non-emergency  services,
inform  a  patient  or  prospective patient that the amount or estimated
amount the health care professional will bill  the  patient  for  health
care  services  is  available  upon  request;  and (b) upon receipt of a
request from a patient or prospective patient, disclose to  the  patient
or  prospective  patient  in  writing the amount or estimated amount or,
with respect to a health center, a schedule of fees  provided  under  42
U.S.C.  §  254b(k)(3)(G)(i),  that  the  health care professional, group
practice, diagnostic and treatment center or health  center,  will  bill
the  patient or prospective patient for health care services provided or
anticipated to be provided to the patient or prospective patient  absent
unforeseen  medical  circumstances  that  may arise when the health care
services are provided.
3. A health care professional who  is  a  physician  shall  provide  a
patient  or  prospective  patient  with the name, practice name, mailing
address, and telephone number of any health care provider  scheduled  to
perform  anesthesiology,  laboratory,  pathology, radiology or assistant
surgeon  services  in  connection  with  care  to  be  provided  in  the
physician's  office  for  the  patient or coordinated or referred by the
physician for the patient at the time of referral to or coordination  of
services with such provider.
4.  A  health  care  professional  who  is  a  physician  shall, for a
patient's scheduled hospital admission or scheduled outpatient  hospital
services,  provide  a  patient  and the hospital with the name, practice
name, mailing address and telephone number of any other physician  whose
services will be arranged by the physician and are scheduled at the time
of  the  pre-admission  testing,  registration  or admission at the time
non-emergency services are scheduled;  and  information  as  to  how  to
determine the healthcare plans in which the physician participates.
5.  A hospital shall establish, update and make public through posting
on the hospital's website, to the extent required by federal guidelines,
a list of  the  hospital's  standard  charges  for  items  and  services
provided   by  the  hospital,  including  for  diagnosis-related  groups
established under section 1886(d)(4) of the federal social security act.
6. A hospital shall post on the hospital's  website:  (a)  the  health
care  plans  in  which  the  hospital is a participating provider; (b) a
statement that (i) physician services provided in the hospital  are  not
included in the hospital's charges; (ii) physicians who provide services
in  the  hospital  may  or may not participate with the same health care
plans as the hospital, and; (iii) the prospective patient  should  check

with  the physician arranging for the hospital services to determine the
health  care  plans  in  which  the  physician  participates;   (c)   as
applicable,  the  name,  mailing  address  and  telephone  number of the
physician  groups  that  the  hospital  has  contracted  with to provide
services  including  anesthesiology,   pathology   or   radiology,   and
instructions  how  to  contact these groups to determine the health care
plan participation of  the  physicians  in  these  groups;  and  (d)  as
applicable,   the   name,  mailing  address,  and  telephone  number  of
physicians employed by the hospital and whose services may  be  provided
at the hospital, and the health care plans in which they participate.
7.  In  registration  or  admission  materials  provided in advance of
non-emergency hospital  services,  a  hospital  shall:  (a)  advise  the
patient or prospective patient to check with the physician arranging the
hospital  services  to  determine:  (i) the name, practice name, mailing
address and telephone number of any other physician whose services  will
be  arranged  by  the  physician;  and  (ii)  whether  the  services  of
physicians who are employed or contracted by  the  hospital  to  provide
services   including  anesthesiology,  pathology  and/or  radiology  are
reasonably anticipated to be provided to the patient;  and  (b)  provide
patients  or  prospective  patients with information as to how to timely
determine the health care plans participated in by  physicians  who  are
reasonably  anticipated  to  provide  services  to  the  patient  at the
hospital,  as  determined  by  the  physician  arranging  the  patient's
hospital  services,  and who are employees of the hospital or contracted
by the hospital to provide services including anesthesiology,  radiology
and/or pathology.
8.  A  health  care  professional,  or a group practice of health care
professionals, a diagnostic and treatment  center  or  a  health  center
defined  under  42  U.S.C. § 254b on behalf of health care professionals
rendering services at  the  group  practice,  diagnostic  and  treatment
center  or  health center, and a hospital shall make publicly available,
and if applicable,  post  on  their  public  websites,  and  provide  to
individuals  who  are enrollees of health care plans, a one-page written
notice, in clear and understandable language, containing information  on
the  requirements  and  prohibitions  under  42  U.S.C. §§ 300gg-131 and
300gg-132 and article six of the  financial  services  law  relating  to
prohibitions  on  balance  billing  for  emergency services and surprise
bills, and information  on  contacting  appropriate  state  and  federal
agencies  if  an individual believes a health care provider has violated
any requirement described in 42 U.S.C. §§  300gg-131  and  300gg-132  or
article six of the financial services law.
9. For purposes of this section:
(a)  "Health  care  plan"  means a health insurer including an insurer
licensed to write accident  and  health  insurance  subject  to  article
thirty-two  of  the  insurance  law; a corporation organized pursuant to
article forty-three of the insurance law; a municipal cooperative health
benefit plan certified pursuant to article forty-seven of the  insurance
law;  a  health  maintenance  organization certified pursuant to article
forty-four of  this  chapter;  a  student  health  plan  established  or
maintained  pursuant  to section one thousand one hundred twenty-four of
the insurance law or a self-funded employee welfare benefit plan.
(b)  "Health  care  professional"  means  an  appropriately  licensed,
registered or certified health care professional pursuant to title eight
of the education law.
(c)  "Hospital" means a general hospital as defined in subdivision ten
of section two thousand eight hundred one of this chapter.