N.Y. consumer hotline recovers nearly $2 million in restitution and savings: LongIsland.com

Filed Under: Costs, Patients, Providers

“Attorney General Eric T. Schneiderman today released a report detailing the work of his Health Care Bureau’s Helpline, a free service offered by the Office of the Attorney General that has investigated and resolved over 2,500 consumer complaints during the past year – saving or returning almost $2 million in health care expenses to consumers,” Darko Stojanovic writes at LongIsland.com. “… The Attorney General’s toll-free HCB Helpline – 800-428-9071 – is available for New Yorkers to report and resolve health care complaints and concerns ranging from simple payment processing errors to complex deceptive business practices. … During 2017, Helpline staff handled 2,515 consumer complaints and provided another 3,050 consumers with information or referred them to an appropriate agency for assistance. …  In one case, a consumer contacted the Helpline because she was being billed more than $24,000 by a hospital for the care of one of her twins after birth.  After a Helpline advocate intervened, the denial of coverage was reversed. In another case, a consumer contacted the Helpline regarding her health plan’s denial of  coverage for prescription medication for her son who was taking a particular medication (Quillivant XR) that, after trying other medications, was the only medication that successfully treated the son’s ADHD.  …The health plan had denied continuation of the prescription as not medically necessary, leaving the child without medication for almost two weeks.  Once a Helpline advocate intervened, the medication was approved. A consumer contacted the Helpline because while the health plan agreed to pay in full for the consumer’s gender reassignment surgery, the plan only paid half. After a Helpline advocate filed an inquiry, the plan paid in full as agreed. The Helpline advocate also discovered that the consumer had to pay out-of-pocket for other covered procedures that the health plan denied coverage for. The Helpline advocate filed a second inquiry, and the denial of coverage was reversed. Restitution to the consumer totaled $9,700. After receiving a complaint that Brooklyn Hospital Medical Center had illegally billed a sexual assault survivor seven separate times for a forensic rape exam (FRE) administered in the hospital’s emergency room, the HCB conducted an investigation that found that in 85 out of 86 cases between 2015 and 2017, the hospital either improperly billed the patient directly, or billed the patient’s insurance plan without advising the patient of the choice of payment options as required by law. …The Attorney General’s office secured a settlement requiring Brooklyn Hospital to pay restitution to improperly billed survivors, maintain and properly disseminate a Sexual Assault Victim Policy that prevents improper billing, and pay $15,000 to New York State. The investigation also led to HCB’s statewide investigation of improper hospital billing for FREs, which is currently under way.” Darko Stojanovic, “A.G. Schneiderman’s Health Care Helpline Recovers Nearly $2 Million In Restitution And Savings For Consumers,” LongIsland.com.