To: The New York State House, The New York State Senate, and Governor Andrew Cuomo
Require Health Insurance Companies to pay a realistic amount for Out-of-Network Service
The health insurance industry is thwarting their agreement to base what they will reimburse for out-of-network coverage on actual 'usual and customary' fees charged by health providers.
Health insurance companies reached a settlement in 2009 with NYS requiring them to set up a data base to determine how much to reimburse for those policies that provided for out-of-network service. The insurance industry spent $90 million to create this data base. But since they were not obligated to use it, they are now basing their reimbursement amounts on Medicare rates, which are much lower.
“They’re not getting what they think they’re paying for,” said Benjamin M. Lawsky, the superintendent of the New York State Department of Financial Services, whose investigators recently found that under the switch, 4.7 million New York State residents — 76 percent of those with out-of-network coverage — are facing reimbursement reductions of 50 percent or more.
Mr. Lawsky, who worked for Mr. Cuomo when he was attorney general, is seeking legislation in New York State to require that minimum reimbursements be linked to the new database, known as Fair Health.
Please sign this petition which will be delivered to the New York State Legislature and help Mr. Lawsky!
Here is the link to a New York Times article detailing the abuse by the insurance industry:
http://www.nytimes.com/2012/04/24/nyregion/health-insurers-switch-baseline-for-out-of-network-charges.html?pagewanted=1&_r=1&hp
Health insurance companies reached a settlement in 2009 with NYS requiring them to set up a data base to determine how much to reimburse for those policies that provided for out-of-network service. The insurance industry spent $90 million to create this data base. But since they were not obligated to use it, they are now basing their reimbursement amounts on Medicare rates, which are much lower.
“They’re not getting what they think they’re paying for,” said Benjamin M. Lawsky, the superintendent of the New York State Department of Financial Services, whose investigators recently found that under the switch, 4.7 million New York State residents — 76 percent of those with out-of-network coverage — are facing reimbursement reductions of 50 percent or more.
Mr. Lawsky, who worked for Mr. Cuomo when he was attorney general, is seeking legislation in New York State to require that minimum reimbursements be linked to the new database, known as Fair Health.
Please sign this petition which will be delivered to the New York State Legislature and help Mr. Lawsky!
Here is the link to a New York Times article detailing the abuse by the insurance industry:
http://www.nytimes.com/2012/04/24/nyregion/health-insurers-switch-baseline-for-out-of-network-charges.html?pagewanted=1&_r=1&hp
Why is this important?
Health insurance companies reached a settlement in 2009 with NYS requiring them to set up a data base to determine how much to reimburse for those policies that provided for out-of-network service. The insurance industry spent $90 million to create this data base. But since they were not obligated to use it, they are now basing their reimbursement amounts on Medicare rates, which are much lower.