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Published online by Cambridge University Press: 06 January 2021
In September of 2014, Elisabeth Rosenthal of The New York Times detailed a burgeoning problem she termed “drive-by-doctoring,” a practice in which patients go to the hospital for surgery with an in-network physician who, without the patient's knowledge or consent, is assisted by, or consults with, an out-of-network physician during the procedure. While the in-network physician's costs are covered by the patient's insurance, the out-of-network physician charges large fees for her participation, which typically are not fully covered by the patient's insurance plan and are instead passed directly through to the patient. Patients wake from surgery with surprise medical bills that can total over one hundred thousand dollars. Providers typically attempt to collect the full amount of these surprise charges, which “can be especially significant because … they may involve out-of-network providers who bill 20 to 40 times the usual local rates ….”
1 Elisabeth Rosenthal, After Surgery, Surprise $117,000 Medical Bill from Doctor He Didn't Know, N.Y. Times (Sept. 20, 2014), http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?_r=1.
2 See, e.g., id. (describing the story of a patient who was billed $3,000 to meet his deductible from his in-network physician, but received a $117,000 medical bill from an out-of-network physician he did not even know).
3 See, e.g., id. (describing a patient who was “blindsided” by a $117,000 medical bill from an assistant surgeon who the patient “did not recall meeting”).
4 See, e.g., id. (describing a patient who received a $117,000 medical bill from an assistant surgeon after his procedure).
5 Id.
6 See, e.g., DiCarlo v. St. Mary Hosp., 530 F.3d 255, 264 (3d Cir. 2008) (finding that ambiguity of medical contracts with regards to price is “the only practical way in which the obligations of the patient to pay can be set forth”) (adopting the United States District Court for the District of New Jersey's decision).
7 Infra Part III.D.
8 Infra Part III.B-C.
9 Infra note 150 and accompanying text.
10 Wal-Mart Stores, Inc. v. Dukes, 131 S. Ct. 2541, 2550-52 (2011) (interpreting commonality to require that class members must have suffered the same injury, not just that they have all suffered violation of the same provision of law).
11 18½ N.Y. Fin. Serv. Law §§ 601-08 (McKinney 2016); 44 N.Y. Pub. Health Law § 24 (McKinney 2016).
12 See Rosenthal, supra note 1.
13 Jessica C. Smith & Carla Medalia, U.S. Census Bureau, Health Insurance Coverage in the United States: 2013 2, 14 (2014), http://www.census.gov/content/dam/Census/library/publications/2014/demo/p60-250.pdf [perma.cc/52TQ-TBNM].
14 Jack Hoadley et al., Unexpected Charges: What States are Doing About Balance Billing 2 (2009), http://californiaacep.org/wp-content/uploads/Unexpected_Charges_What_States_are_Doing_About_Balance_Billing_California_Healthcare_Foundation_April_2009.pdf [http://perma.cc/4ZY7-94V2].
15 Id.
16 Id.
17 Id.
18 See State Restriction Against Providers Balance Billing Managed Care Enrollees, The Henry J. Kaiser Family Foundation, http://kff.org/private-insurance/state-indicator/state-restriction-against-providers-balance-billing-managed-care-enrollees/ [http://perma.cc/Q8R3-8CVF] [hereinafter State Restriction Against Providers].
19 Nation, George A. III, Determining the Fair and Reasonable Value of Medical Services: The Affordable Care Act, Government Insurers, Private Insurers and Uninsured Patients, 65 Baylor L. Rev. 425, 450-51 (2013)Google Scholar [hereinafter Nation, Fair and Reasonable Value].
20 Id. at 444.
21 42 U.S.C. § 1396a(n)(3)(B) (2012).
22 Hoadley et al., supra note 14, at 6.
23 See State Restriction Against Providers, supra note 18.
24 Id.
25 Id.
26 Hoadley et al., supra note 14, at 3.
27 See State Restriction Against Providers, supra note 18.
28 See Managed Care Programs, National Center for Biotechnology Information, http://www.ncbi.nlm.nih.gov/mesh?term=managed%20care (last visited Feb. 18, 2016).
29 See Lacie Glover, Huge Medical Bill? Balance Billing Might Be to Blame, U.S. News & World Report (Feb. 20, 2015), http://health.usnews.com/health-news/health-wellness/articles/2015/02/20/huge-medical-bill-balance-billing-might-be-to-blame [http://perma.cc/8SXC-6AQG]; State Restriction Against Providers, supra note 18.
30 See State Restriction Against Providers, supra note 18.
31 See id.
32 See Karen Pollitz et al., Medical Debt Among People with Health Insurance, The Henry J. Kaiser Family Foundation 10 (2014), https://kaiserfamilyfoundation.files.wordpress.com/2014/01/8537-medical-debt-among-people-with-health-insurance.pdf [perma.cc/Z737-HMXJ].
33 See, e.g., Rosenthal, supra note 1 (explaining that a man received $117,000 in medical bills after surgery due to out-of-network fees); Jodie Tillman, Even with In-Network Hospital, Insurance May Not Cover ER Physicians, Tampa Bay Times (Sept. 19, 2014), http://www.tampabay.com/news/health/balance-billing-can-mean-unexpected-pain-for-emergency-room-patients/2198506 [perma.cc/39TF-6VBP] (describing how a couple received a $1,235 medical bill for seeing an out-of-network physician at an in-network hospital).
34 See generally Kelly A. Kyanko et al., Out-of-Network Physicians: How Prevalent Are Involuntary Use and Cost Transparency? Health Servs. Res. & Educ. Trust 1154 (2013) (finding that involuntary out-of-network care is prevalent).
35 Id. at 1163-64.
36 Id. at 1165.
37 Id.
38 Id. at 1166.
39 Pollitz et al., supra note 32, at 10.
40 See id.
41 Stacey Pogue & Megan Randall, Center for Public Policy Priorities, Surprise Medical Bills Take Advantage of Texans: Little-Known Practice Creates a “Second Emergency” for ER Patients 3 (2014), http://forabettertexas.org/images/HC_2014_09_PP_BalanceBilling.pdf [http://perma.cc/97FY-VFE8].
42 See Rosenthal, supra note 1.
43 See Nicholas Bagley, Is Drive-By Doctoring Legal?, The Incidental Economist (Sept. 23, 2014, 11:58 AM), http://theincidentaleconomist.com/wordpress/is-drive-by-doctoring-legal/ [http://perma.cc/M5FC-U7A3].
44 See id; OHP Client Agreement to Pay for Health Services, Oregon Health Authority, https://apps.state.or.us/Forms/Served/oe3165.pdf [https://perma.cc/W9CE-QKDV]; Patient Financial Agreement, Newport Integrated Behavioral Healthcare, Inc., http://www.nibhinc.com/patient_financial_agreement.pdf [http://perma.cc/MQ6N-MDS4]; Patient Information/Medical Cost Agreement To Pay, Hearts South, P.C., http://heartssouthpc.com/Documents/Patient%20Information.pdf [http://perma.cc/64K2-66YF]. For examples of standard patient agreements.
45 See Patient Information/Medical Cost Agreement To Pay, supra note 44, at 2.
46 See generally Hayward, Richard, Balancing Certainty and Uncertainty in Clinical Medicine, 48 Developmental Med. & Child Neurology 74 (2006)CrossRefGoogle ScholarPubMed (discussing uncertainty in medicine).
47 See id. at 75.
48 See Arrow, Kenneth J., Uncertainty and the Welfare Economics of Medical Care, 53 Am. Econ. Rev. 941, 951-952 (1963)Google Scholar.
49 See Hall, Mark A. & Schneider, Carl E., Patients as Consumers: Courts, Contracts, and the New Medical Marketplace, 106 Mich. L. Rev. 643, 647-48 (2008)Google ScholarPubMed, for an in-depth discussion of the problem of medical care as a series of unknowable contracts.
50 See text accompanying note 49.
51 See Hall & Schneider, supra note 49, at 652.
52 Id. at 653.
53 Id. at 655 n.56 (quoting Atul Gawande, Piecework: Medicine's Money Problem, New Yorker Apr. 4, 2005, http://www.newyorker.com/magazine/2005/04/04/piecework [http://perma.cc/FX8L-59ET].
54 See id. at 672 (“[M]odern courts usually use gap-filing conventions” to fill in vague contracts.).
55 Restatement (First) of Contracts § 32 (Am. Law Inst. 1932).
56 Hall & Schneider, supra note 49, at 672.
57 See Scott, Robert E., A Theory of Self-Enforcing Indefinite Agreements, 103 Colum. L. Rev. 1641, 1643 (2003)CrossRefGoogle Scholar.
58 Id. at 1643.
59 Hall & Schneider, supra note 49, at 673-74.
60 DiCarlo v. St. Mary Hosp. 530 F.3d 255, 264 (3d Cir. 2006) (adopting the United States District Court for the District of New Jersey opinion) (internal quotation marks omitted).
61 Allen v. Clarian Health Partners, Inc., 980 N.E.2d 306, 310-11 (Ind. 2012) (citing other courts that have reached similar conclusions).
62 Shelton v. Duke Univ. Health Sys. Inc., 33 S.E.2d 113, 116 (N.C. Ct. App. 2006) (noting that “[i]t would be cumbersome, and against patients' interests, to require hospitals to seek new authorization from a patient whenever some medical circumstance requires a new course of treatment. For this reason, it is entirely reasonable and predictable that patients would agree to pay the hospital's regular rates for whatever services might be necessary”).
63 See, e.g., DiCarlo, 530 F.3d at 263 (noting that plaintiff's argument that the contract between himself and the hospital failed for indefiniteness “ha[s] facial persuasiveness, [but] fail[s] to take into account the peculiar circumstances of hospitals, such as St. Mary's, and the bearing these circumstances have upon the interpretation of contracts between a patient and the hospital”).
64 See id.
65 See infra notes 68-76 and accompanying text.
66 See infra notes 77-85 and accompanying text.
67 See infra notes 68-85 and accompanying text.
68 See infra notes 74-76 and accompanying text.
69 See, e.g., Skinner, Daniel, Defining Medical Necessity Under the Patient Protection and Affordable Care Act, 73 Pub. Admin. Rev., S49, S49-S51 (2013)CrossRefGoogle Scholar (arguing that the ACA does not provide adequate medical necessity standards).
70 Id. at S49. (emphasis in original).
71 Infra notes 72-73 and accompanying text.
72 Cal. Welf. & Inst. Code § 14059.5 (Deering 1985); Cowan v. Myers, 187 Cal. App. 3d 968, 975 (Ct. App. 1986) (quoting Cal. Welf. & Inst. Code § 14059.5 (West 2016)).
73 42 U.S.C. § 1395y(a)(1)(A) (2012); What Part A Covers, https://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html [http://perma.cc/5HL7-B69L]; What Part B Covers, https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html [http://perma.cc/7BDP-GCKU].
74 See infra note 76 and accompanying text.
75 See id.
76 Sarchett v. Blue Shield of Cal., 729 P.2d 267, 275 (Cal. 1987).
77 See, e.g., Allen v. Clarian Health Partners, Inc., 980 N.E.2d 306, 308-09 (Ind. 2012) (“This breach of contract claim rests on a critical underlying premise, namely, that the contract lacks the material term of price, and because no price term is present a “reasonable price” is imputed to the contract.”).
78 See id; Patient Financial Agreement, supra note 44; Patient Information/Medical Cost Agreement to Pay, supra note 44.
79 See infra note 80 and accompanying text.
80 DiCarlo v. St. Mary Hosp., 530 F.3d 255, 263 (3rd Cir. 2008).
81 Id. at 264.
82 See, e.g., Holland v. Trinity Health Care Corp., 791 N.W.2d 724, 726 (Mich. App. 2010) (applying the DiCarlo reasoning to the phrase “usual and customary charge”); Shelton v. Duke Univ. Health Sys., Inc., 633 S.E.2d 113, 115-16 (N.C. App. 2006) (applying the DiCarlo reasoning to the phrase “regular rates and terms of the Hospital”); Nygaard v. Sioux Valley Hosps. & Health Sys., 731 N.W.2d 184, 191 (S.D. 2007) (applying the DiCarlo reasoning to the phrase “full, unspecified and undiscounted charges for medical care”).
83 See infra notes 84-85.
84 Temple Univ. Hosp., Inc. v. Healthcare Mgmt. Alternatives, Inc., 832 A.2d 501, 509 (Pa. Super. 2003).
85 Colomar v. Mercy Hosp., Inc. 461 F. Supp. 2d 1265, 1269 (S.D. Fla. 2006).
86 Infra notes 89-90.
87 See, e.g., Greisman v. Newcomb Hosp., 192 A.2d 817, 824 (N.J. 1963) (“The … Hospital is the only hospital in the Vineland metropolitan area and it is publicly dedicated, primarily to the care of the sick and injured of [the community] and its vicinity and …. [d]octors need hospital facilities and a physician practicing in the metropolitan … area ….”).
88 Grodjesk v. Jersey City Med. Ctr., 343 A.2d 489, 501 (N.J. Super. Ct. 1975).
89 Hall & Schneider, supra note 49, at 678-683.
90 Id. at 680 (quoting Burton v. William Beaumont Hosp., 373 F. Supp. 2d 707, 724 (E.D. Mich. 2005)) (internal quotation marks omitted); see also Hill v. Sisters of St. Francis Health Servs., Inc., No. 06 C 1488, 2006 WL 3783415, at *3 (N.D. Ill. Dec. 20, 2006) (“[T]here is no fiduciary relationship between a hospital and its patients with respect to billing practices.”).
91 Restatement (Second) of the Law of Agency § 8.11 cmt. c, illus. 10 (Am. Law. Inst. 2006).
92 Abbitt v. Gregory, 160 S.E. 896, 906 (1931).
93 For a more detailed analysis of the fiduciary nature of the doctor patient relationship, with specific regard to balance billing, see Hall & Schneider, supra note 49 at 678-683.
94 Supra notes 86-90 and accompanying text.
95 See infra note 96 and accompanying text.
96 See, e.g., Hume v. United States, 132 U.S. 406, 411 (1889) (“It may be apparent from the intrinsic nature and subject of the bargain itself, such as no man in his senses and not under delusion would make on the one hand, and as no honest and fair man would accept on the other ….”).
97 U.C.C. § 2-302 cmt. 1 (Am. Law Inst. 2000).
98 See generally Leff, Arthur Allen, Unconscionability and the Code-The Emperor's New Clause, 115 U. Pa. L. Rev. 485 (1967)CrossRefGoogle Scholar (distinguishing “two interests [in contract law] … refer[ing] to bargaining naughtiness as ‘procedural unconscionability,’ and to the evils in the resulting contract as ‘substantive unconscionability’”).
99 Nation, George A. III, Obscene Contracts: The Doctrine of Unconscionability and Hospital Billing of the Uninsured, 94 Ky. L.J. 101, 110 (2005-2006)Google Scholar [hereinafter Nation, Obscene Contracts].
100 Id. at 101 (Nation describes the story of Ms. Nix, whose “[medical] bill was $14,000, New York Methodist is only reimbursed about $2,500 by [HMOs] for the same two-day hospital stay!”).
101 Id. at 110-11 (citing Williams v. Walker-Thomas Furniture Co., 350 F.2d 445, 449 (D.C. Cir. 1965)).
102 Id. at 111 (citing Phoenix Baptist Hosp. & Med. Ctr. v. Aiken, 877 P.2d 1345, 1350 (Ariz. Ct. App. 1994)).
103 Id. at 111-12.
104 Id. at 112.
105 Id. at 111 (citing Ting v. AT&T, 319 F.3d 1126, 1148 (9th Cir. 2003)).
106 Rosenthal, supra note 1.
107 Nation, Fair and Reasonable Value, supranote 19, at 444.
108 Nation, Obscene Contracts, supra note 99, at 104.
109 See supra text accompanying note 106.
110 See Nation, Obscene Contracts, supra note 99, at 112 (“[T]hese agreements are entered into in circumstances where the patient has little opportunity to understand the terms offered ….”).
111 See e.g., Armendariz v. Found. Health Psychcare Servs., 6 P.3d 669, 690 (Cal. 2000) (explaining that the procedural element of unconscionability is based upon “oppression” or “surprise” from “unequal bargaining power”).
112 Nation, Obscene Contracts, supra note 99, at 112.
113 See, e.g., Watson, Sidney D., Mending the Fabric of Small Town America: Health Reform & Rural Economies, 113 W. Va. L. Rev. 1, 7 (2010)Google Scholar (“[R]ural communities suffer from such a dire shortage of health care providers that even those who have health insurance or money to pay for care often cannot find a provider to treat them.”).
114 Bank of Ind., Nat'l Ass'n v. Holyfield, 476 F. Supp. 104, 110 (S.D. Miss. 1979).
115 Belcher v. Kier, 558 So. 2d 1039, 1043 (Fla. Dist. Ct. App. 1990).
116 Bank of Ind., Nat'l Ass'n, 476 F. Supp. at 110 (citing Hume v. United States, 132 U.S. 406 (1889); Denkin v. Sterner, 10 Pa. D. & C.2d 203 (1956)).
117 Nation, Obscene Contracts, supra note 99, at 113-14.
118 See Jan L. Weinstock, Competitive Providers of Managed Healthcare, N.J. Law 11, 11 (1987) (“Under fee-for-service billing, a practitioner charges separately for each patient encounter and service rendered” so that “the greater the number of services rendered, the greater the cost to the patient and the patient's insurer.”).
119 See, e.g., Medicaid Non-Emergency Out-of-Network Payment Study, The Lewin Group 5 (July 13, 2009), http://www.mhpa.org/_upload/OutofNetworkLewinReport.pdf [http://perma.cc/6RTX-TELH] (“[F]ederal regulations stipulat[ing] that Medicare health plans are required to pay providers at the Medicare payment rate for all out-of-network care.”).
120 See State Restriction Against Providers, supra note 18 (showing that only thirteen states restrict out-of-network providers from balance billing managed care enrollees).
121 See id.
122 Williams v. Walker-Thomas Furniture Co., 350 F.2d 445, 449 (D.C. Cir. 1965).
123 Id.
124 Nation, , Obscene Contracts, supra note 99, at 113-14 (quoting Ellsworth Dobbs, Inc. v. Johnson, 236 A.2d 843, 856 (N.J. 1967)) (internal quotation marks omitted).
125 See Hume v. United States, 132 U.S. 406, 414 (1889).
126 Nation, Obscene Contracts, supra note 99, at 114.
127 See, e.g., Frostifresh Corp. v. Reynoso, 274 N.Y.S.2d 757 (N.Y. Dist. Ct. 2d. 1966) (judgment reversed for new trial with respect to damages).
128 See, e.g., Jones v. Star Credit Corp., 298 N.Y.S.2d 264, 264-65 (N.Y. Sup. Ct. 1969) (“[T]he value disparity itself leads inevitably to the felt conclusion that knowing advantage was taken of the plaintiffs.”).
129 See Brown, Evelyn L., The Uncertainty of U.C.C. Section 2-302: Why Unconscionability Has Become a Relic, 105 Com. L.J. 287, 299 (2000)Google Scholar (quoting Ahern v. Knecht, 563 N.E.2d 787, 792 (Ill. App. Ct. 1990)) (holding that “[g]ross excessiveness of price alone can make an agreement unconscionable”) (internal quotation marks omitted).
130 Nation, Fair and Reasonable Value, supra note 19, at 434, 443.
131 Id.
132 Tunkl v. Regents of Univ. of Cal., 383 P.2d 441, 447 (Cal. 1963).
133 Nation, Fair and Reasonable Value, supra note 19, at 446-47.
134 See id. at 431.
135 See Hall & Schneider, supra note 49, at 663 (“The egregious failure of the hospital market is revealed by the astonishing differences between what hospitals nominally charge and what insured patients pay.”).
136 See id. at 666-67 (“Adequate markets permit–indeed, help–consumers shop for good services at good prices…. Nevertheless, many physicians and most hospitals exploit their market power to induce patients to agree to pay what they are asked and then charge the uninsured fabulously more than the insured.”).
137 See id. at 648; Adam Smith, Library of Economics & Liberty, http://www.econlib.org/library/Enc/bios/Smith.html [http://perma.cc/GU5C-53FK].
138 Nation, Obscene Contract, supra note 99, at 115.
139 DiCarlo v. St. Mary Hosp., 530 F.3d 255, 264 (3rd Cir. 2008).
140 Id.
141 Temple Univ. Hosp., Inc. v. Health Care Mgmt. Alternatives, Inc., 832 A.2d 501, 509 (Pa. Super. Ct. 2003).
142 See supra text accompanying notes 106, 107.
143 Id.
144 Hoadley et al., supra note 14, at 4.
145 Bagley, supra note 43.
146 Id.
147 See generally Schneider, Carl E. & Hall, Mark A., The Patient Life: Can Consumers Direct Health Care? 35 Am. J.L. & MeD. 7 (2009)CrossRefGoogle ScholarPubMed (analyzing consumerism and concluding that “people in a consumerist world would choose health plans, providers, and treatments, … [and] at every stage people would encounter daunting hurdles.”).
148 Schneider & Hall, supra note 49, at 671-72 (establishing a “supervisory doctrine” where courts can “(1) fill in missing contract terms or declare contracts void for vagueness, (2) amend or refuse to enforce unconscionable contracts, and (3) evaluate the fairness of fiduciaries' behavior.”).
149 See id. at 672-73.
150 See id.
151 18½ N.Y. Fin. Serv. Law §§ 601-08 (McKinney 2016).
152 See Larry Ribstein & Bruce H. Kobayashi, The Economics of Federalism 6 (Ill. Law and Economics Working Papers Series, Working Paper No. LE06-001, 2006).
153 See Tiebout, Charles M., A Pure Theory of Local Expenditures, 64 J. Pol. Econ. 416, 416 (1956)CrossRefGoogle Scholar (putting forth a model that “yields a solution for the level of expenditures for local public goods which reflects the preferences of the population more adequately than they can be reflected at the national level”).
154 See, e.g., Easterbrook, Frank H., Antitrust and the Economics of Federalism, 26 J.L. & Econ. 23 (1983)CrossRefGoogle Scholar (discussing the application of Tiebout theory to antitrust); Johnston, Jason Scott, A Positive Political Economic Theory of Environemntal Federalization, 64 Case W. Res. L. Rev. 1549 (2014)Google Scholar (discussing the application of Tiebout theory to environmental law).
155 See Moncrieff, Abigail R., Federalization Snowballs: The Need for National Action in Medical Malpractice Reform, 109 Colum. L. Rev. 844 (2009)Google Scholar (arguing for the federalization of medical malpractice).
156 See generally Easterbrook, supra note 154; Johnston, supra note 154.
157 See Moncrieff, supra note 155.
158 See id. at 852-55.
159 Ribstein & Kobayashi, supra note 152, at 5.
160 See, e.g., Robert L. Glicksman, Federal Preemption by Inaction, in Preemption Choice: The Theory, law, and Reality of Federalism's Core Question 174 (William W. Buzbee, ed., 2009) (“The second ground for express preemption of state regulation in the face of federal inaction is the potential for state regulation to thwart federal goals such as uniformity and minimization of transaction costs.”).
161 See Schwartz, Gary T., Considering the Proper Federal Role in American Tort Law, 38 Ariz. L. Rev. 917, 924 (1996)Google Scholar.
162 Blumstein, James F., A Perspective on Federal and Medical Malpractice, 14 Yale L. & Pol'y Rev. 411, 412 (1996)Google Scholar.
163 Id. at 413-14.
164 See, e.g., New Jersey Hospital Association, Statement of Principles and Guidelines for Hospital Billing and Collection Practices, http://www.aha.org/content/00-10/newjerseyguidelines.pdf [http://perma.cc/KHM8-ZL6Z] (setting guidelines for hospital billing).
165 New State Ice Co. v. Liebmann, 285 U.S. 262, 311 (1932) (Brandeis, J., dissenting).
166 Rosenthal, supra note 1.
167 Moncrieff, supra note 155, at 880.
168 Tiebout, supra note 153.
169 See id. at 418.
170 Id. at 419.
171 26 U.S.C. § 501(r) (2012).
172 See Rhode, Paul W. & Strumpf, Koleman S., Assessing The Importance of Tiebout Sorting: Local Heterogeneity From 1850 to 1990, 93 Am. Econ. Rev. 1648, 1649, 1657 n.22 (2003)CrossRefGoogle Scholar.
173 State Restriction Against Providers, supra note 18.
174 Id.
175 Id.
176 Id.
177 See id.
178 18½ N.Y. Fin. Serv. Law §§ 601-08 (McKinney 2016); 44 N.Y. Pub. Health Law § 24 (McKinney 2016).
179 2014 N.Y. Sess. Laws 569 (McKinney) (The bill was designed “to amend the insurance law, the public health law and the financial services law, in relation to establishing protections to prevent surprise medical bills including network adequacy requirements, claim submission requirements, access to out-of-network care and prohibition of excessive emergency charges ….”).
180 S.B. 6357, 237th Sess. (N.Y. 2013)
181 18½ N.Y. Fin. Serv. Law § 602(b)(2) (McKinney 2016).
182 See id.
183 Id. § 603(h)(1).
184 Id. § 603(h)(2).
185 Id. § 607(a)(2).
186 Id. § 607(a)(4)-(5).
187 27 N.Y. Ins. Law. § 3241 (McKinney 2015).
188 44 N.Y. Pub. Health Law § 24 (McKinney 2016).
189 Id. § 24(1).
190 Id. § 24(2).
191 Id. § 24.
192 18½ N.Y. Fin. Serv. Law §§ 601-08 (McKinney 2016); 27 N.Y. Ins. Law. § 3241 (McKinney 2015); 44 N.Y. Pub. Health Law § 24 (McKinney 2016).
193 Kyanko et al., supra note 34, at 1167; Pollitz et al., supra note 32, at 1.
194 Hall & Schneider, supra note 49, at 678-683.
195 Supra Part III.D.
