NEW YORK – Attorney General Eric T. Schneiderman today released a report highlighting the significant achievements of his Health Care Bureau’s Helpline, a free service offered by the Attorney General’s office that has investigated and resolved approximately 13,000 consumer complaints since 2011, resulting in over $12.5 million in health care expenses being saved or returned to New York consumers. The report, titled “Real Solutions For Real New Yorkers: Health Care Bureau Helpline,” offers a review of some of the assistance provided by Helpline staff, including securing payment of $200,000 from an insurance company for a claim that had been wrongfully denied for operations required after a dog attack, and $100,000 for a mental health hospitalization bill that was initially denied.
“My office’s Health Care Bureau helpline is a free and essential service that is available to all New Yorkers. Consumers should know we have their backs when insurance companies wrongly deny claims, or when a provider overbills,” Attorney General Schneiderman said. “Our Helpline resolves thousands of disputes in the favor of consumers every year. No problem is too big or too small for our Helpline advocates. We know that in America today, too many personal bankruptcies are the result of medical expenses, a situation that is often made worse by improper medical lending practices such as predatory loans or medical credit cards. My office’s Health Care Bureau is committed to ensuring fairness in the health care industry and, in the process, advocating relentlessly on behalf of health care consumers.”
The Attorney General’s toll-free Helpline – 800-428-9071 – is a place for New Yorkers to report, and for advocates to resolve, health care complaints and concerns ranging from simple payment processing errors to complex deceptive business practices. From January 1, 2011, through September 30, 2014, Helpline staff resolved 13,011 consumer complaints and provided another 7,281 consumers with requested information or referred them to an appropriate agency for assistance.
The $12.5 million in savings went to nearly 2,500 New Yorkers. Many of the other consumers who called the Helpline were not seeking help with billing issues but were seeking assistance for other urgent problems, including gaining access to medically necessary care. The Helpline staff has successfully mediated these time-sensitive complaints by obtaining reversals of incorrect denials of coverage and expediting insurers’ processing of requests for pre-authorizations for medical procedures, including surgeries, or for necessary in-patient treatment or for medication. Helpline advocates also take the extra step for consumers, working to ensure that any negative effects from improper medical billing or claims are removed from credit reports. Of the more than 20,000 calls received by the Helpline since 2011, 64 percent resulted in an investigation and/or resolution by Helpline staff. Advocates opened an average of 13 cases a day.
The 10 counties with the most helpline callers in New York are:
Albany | 583 |
Nassau | 440 |
Suffolk | 403 |
Kings | 354 |
Westchester | 290 |
Queens | 283 |
Monroe | 240 |
Onondaga | 225 |
Ulster | 208 |
New York | 192 |
“If you believe that you have been treated unfairly by your health insurance, do yourself a favor and let the NYS Attorney General's Office listen and help,” said Dan Benesh, a West Seneca dad who called the Helpline after his insurance company refused to pay for air ambulance transport after his son injured himself in the woods.
Pati Robben, a Rochester area mom of a teenage daughter who was largely immobilized by back pain for a period of weeks this past Spring, said, “My husband and I both work full time and have always had health insurance and paid our premiums. It was extremely disheartening when the insurance company refused to cover a basic bill for a visit to the emergency room, even after my daughter’s doctor told us to take her to the ER. With one child in college and one soon to be - we contacted everyone we could think of, but could get no help. We were stuck. Ultimately, I called the Attorney General’s health care hotline and they were able to help up resolve the issue and the insurance company reversed its decision and paid the bill. We are so appreciative for the timely and supportive help we received – and we are so glad that our daughter is now happily in college!”
Erie County Executive Mark Poloncarzsaid, “Attorney General Schneiderman continues to demonstrate his commitment to New Yorkers through the Health Care Helpline, which has assisted over 20,000 callers since 2011.This toll-free and cost-free service helps consumers navigate the health care maze and find resolution for their complaints while also providing insights into possible abuse of the system by providers.Thanks to Attorney General Schneiderman, health care consumers in New York State have someone on their side to help them resolve their most urgent issues.”
New York State Senator Tim Kennedysaid, “Attorney General Schneiderman’s Health Care Bureau Helpline provides a crucial service to residents of New York state. As more and more New Yorkers gain access to health coverage and services, the Helpline is ensuring that state residents are receiving the care they need and are entitled to. As a State Senator, my office receives a number of calls from constituents who are having issues with their insurers and providers; Attorney General Schneiderman’s Helpline has provided these constituents with the assistance and support they need to resolve their concerns.This is a wonderful service, and I thank the Attorney General for his leadership on this issue.”
New York State Assemblymember Crystal Peoples-Stokessaid, “Buffalo's health industry is growing, with that growth there has to be accountability on the part of the health industry. The Health Care Bureau’s Free Helpline ensures that people’s problems are heard not ignored. Medical expenses can be overwhelming and crippling for patients and their families, some procedures which they never financially recover from. The health care industry has to focus more on improving access to and quality patient care, not forcing individuals to utilize medical credit cards. I applaud Attorney General Schneiderman for establishing the Health Care Bureau and its effective helpline.”
City of Rochester Mayor Lovely Warrensaid, “Attorney General Eric Schneiderman has gone the extra mile in making sure that families aren't crippled by health care bills that rightfully should be covered. He is a powerful advocate for consumers and is making a real difference.”
New York State Senator Ted O'Briensaid, “Access to quality, affordable healthcare should be a given in New York, but too often people find themselves arguing with insurance companies rather than getting the care they need. The Attorney General’s Health Care Helpline has provided consumers with an effective advocate, saving families millions of dollars and ensuring people receive the treatment they are entitled to. I applaud Attorney General Schneiderman for making this important resource available to New Yorkers.”
New York State Assembly Majority Leader Joseph D. Morellesaid, “As elected leaders we have an obligation to protect New York’s health care consumers from predatory practices that expose them to financial exploitation. The Health Care Bureau Helpline has addressed this critical issue head on by acting as a powerful advocacy tool and resource that equips policy holders with the knowledge they need to safeguard themselves and their families when navigating the health care system. I thank and applaud Attorney General Schneiderman for his leadership on this issue and continued efforts to protect New York’s consumers.”
Joseph Kelemen, executive director of the Western New York Law Center,said, “Medical expenses are one of the leading causes of consumer debt in Western New York, often leading to bankruptcy and foreclosure. Medical charges are often incorrectly assessed against consumers, and when they can’t resolve the billing disputes or pay the charges, they fall even further into debt because of interest rates assessed on the bills. The Western New York Law Center applauds Attorney General Schneiderman for giving people a mechanism for addressing this problem and for his strong advocacy on behalf of patients and consumers.”
Karen Nicolson, chief executive officer of Legal Services for the Elderly, Disabled or Disadvantaged of Western New York,said, “Attorney General Schneiderman ‘s dedication to helping New Yorkers eliminate medical debt has been a tremendous help to our elderly and disabled clients. In the past three years, we have regularly referred clients to the Helpline for assistance-- a vital tool in helping New Yorkers of all income levels. Inability to pay for health care can start a spiral of bankruptcy, poverty and homelessness that tears at the fabric of our community. Legal Services for the Elderly, Disabled or Disadvantaged of Western New York, Inc. is committed to continuing to work with A.G. Schneiderman and his dedicated staff to ensure that illness in New York State does not result in financial ruin.”
Trilby de Jung, chief executive officer of the Finger Lakes Health Systems Agency, said, “When trying to resolve medical billing or service disputes, consumers navigate a dauntingly complex health care system. The Attorney General’s Health Care Helpline provides one of the few resources available for free consumer advocacy. That assistance is not only critical for individuals, but is helping to shape a fairer and higher quality health care system for all New Yorkers.”
Geoffrey Hale, Senior Attorney in the Rochester office of the Empire Justice Center, said, “On behalf of Empire Justice Center, I would like to take the opportunity to applaud the exemplary work of Attorney General Eric Schneiderman’s Health Care Bureau. Through their efforts, thousands of New Yorkers have been able to correct erroneous bills, avoid needless expenditures, and receive critical medical care. More than just a resource for consumers, the Health Care Bureau also provides vital assistance to consumer advocates and organizations like Empire Justice. By partnering with the Health Care Bureau on specific issues we have been able to achieve better outcomes for our clients who often face incredibly challenging health coverage problems. We welcome the opportunity to work even more closely with Health Care Bureau in the future."
The Helpline also serves as an important source of consumer information for the Health Care Bureau, which helps providers implement best practices and enables the bureau to bring swift enforcement action when misconduct is discovered. Examples include a 2013 settlement agreement with GE Capital Retail Bank that imposed significant new protections for more than 500,000 New York consumers who had signed up for the company’s health care credit card, CareCredit, which can carry an interest rate of over 26%; and an April 2014 agreement with MyMedicalloan.com that stopped the company from making predatory medical loans, including loans with interest rates of up to 55%. The settlement required $230,000 in repayments or credits to more than 300 consumers.
Money returned or saved for New Yorkers by these Health Care Bureau settlements – totaling more than $24 million in restitution for consumers - are in addition to the $12.5 million saved for New Yorkers via the bureau’s hotline.
The Attorney General’s report also highlights important trends that will help New Yorkers become more educated health care consumers. It offers consumer alerts and tips, the most important of which is that if you encounter a problem with your provider’s billing or business practices or health insurance coverage, you can call the Helpline for assistance.
While not all calls can be resolved in the consumer’s favor, the helpline plays a crucial role in providing reliable, objective information.
For more information about services provided by the Attorney General’s Health Care Bureau Helpline, click here.