New Patient Consent and Billing Requirements

As part of last year’s state budget, new patient consent and billing policies were approved and will take effect on October 20, 2024. These policies, outlined below, present operational and financial challenges for health centers.

CHCANYS has raised these concerns with DOH, and the department has confirmed that guidance is in development. Until that guidance is issued, the October 20 implementation date will remain flexible, with no enforcement expected at this time.

Because these policies are statutory, any changes will require legislative action through the next state budget, and CHCANYS is actively pursuing a solution. We are also working closely with DOH and other stakeholders to address the impact on health centers and will share updates as new information becomes available.

The new requirements from the Public Health Law and General Business Law are included below:

Updates to NY Public Health Law:

§ 18-c. Informed consent from a patient to provide any treatment, procedure, examination or other direct health care services shall be obtained separately from such patient's consent to pay for the services. Consent to pay for any health care services by a patient shall not be given prior to the patient receiving such services and discussing treatment costs. For purposes of this section, "consent" means an action which:

  1. clearly and conspicuously communicates the individual's authorization of an act or practice;
  2. is made in the absence of any mechanism in the user interface that has the purpose or substantial effect of obscuring, subverting, or impairing decision-making or choice to obtain consent; and
  3. cannot be inferred from inaction.

Updates to NY General Business Law: 

 § 349-g. Restrictions on applications for and use of credit cards and medical financial products.

  • For purposes of this section, the following terms shall have the following meanings: 
  1. "Medical financial products" shall mean medical credit cards and third-party medical installment loans. 
  2. "Health care provider" shall mean a health care professional licensed, registered or certified pursuant to title eight of the education law. 
  3. "Medical credit card" shall mean a credit card issued under an open-end or closed-end plan offered specifically for the payment of health care services, products, or devices provided to a person. 
  • It shall be prohibited for any hospital or health care provider, or employee or agent of a hospital or health care provider, to complete any portion of an application for medical financial products for the patient or otherwise arrange for or establish an application that is not completely filled out by the patient.

§ 519-a. Credit cards and payment for health care services.

  1. For purposes of this section, the term "credit card" shall have the same meaning as in section five hundred eleven of this article.
  2. No hospital or health care provider shall require credit card pre-authorization nor require the patient to have a credit card on file prior to providing emergency or medically necessary medical services to such patient.

Hospitals and health care providers shall notify all patients about the risks of paying for medical services with a credit card. Such notification shall highlight the fact that by using a credit card to pay for medical services, the patient is forgoing state and federal protections that regard medical debt. The commissioner of health shall have the authority and sole discretion to set requirements for the contents of such notices.

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