Navigating New York’s Medical Cost Transparency Laws

Understanding New York‘s New Patient Consent Laws

Navigating the world of medical bills and patient rights can feel overwhelming, especially when new laws come into play. Here in New York, significant changes are happening to empower you regarding your healthcare costs. New York State Public Health Law Section 18-c aims to provide more financial transparency and greater control over your medical decisions and billing practices.

This important law, initially effective October 20, 2024, requires healthcare providers to obtain your consent for treatment separately from your consent to pay for those services. It is a big step towards ensuring you understand what you are agreeing to before facing unexpected charges. We want to walk you through what this means for you and your family.

What Is NYS Public Health Law 18-c?

New York State Public Health Law Section 18-c is a consumer protection measure designed to enhance patient rights. The law mandates that healthcare providers secure two distinct forms of consent from you. First, you must give informed consent for any treatment, procedure, examination, or other direct health care services. Second, you must provide separate consent to pay for those services.

Crucially, your consent to pay for health care services cannot be given until after you receive those services and have a chance to discuss the associated costs. This provision aims to prevent situations where patients unknowingly agree to financial obligations without full understanding. The law also defines “consent” very clearly. It must be an action that unmistakably communicates your authorization. Also, consent cannot be inferred from your inaction. It must be explicit, not merely implied.

This means healthcare providers must ensure their consent processes are transparent and do not obscure your ability to make informed decisions. For instance, if you were to receive a procedure, you would first agree to the medical treatment itself. Then, after the treatment and a discussion about the costs, you would provide a separate agreement to pay. This separation gives you a clearer picture of your financial responsibilities.

The Impact of Separate Consent for Treatment and Payment

The requirement for separate consent forms for treatment and payment represents a significant shift from past practices. Many providers previously used a single form for both, which could sometimes lead to confusion about financial obligations. Now, the law insists on distinct documentation. This change empowers you by ensuring that your focus on health and healing is not intertwined with immediate financial commitments.

For example, imagine you are in a doctor’s office for a non-emergency procedure. Under this law, you would first sign a form agreeing to the procedure itself, understanding its medical aspects. Then, after the procedure is complete and you have had a discussion about the bill, including any out-of-pocket costs or insurance considerations, you would then provide your consent to pay. This two-step process helps you make financial decisions with more information.

The law also addresses concerns about certain payment practices. It prohibits healthcare providers from keeping your credit card on file or requiring preauthorization of payment before delivering emergency or medically necessary services. This protection helps prevent situations where patients might feel pressured into financial arrangements during vulnerable times. Also, the law mandates new notices to patients. These notices must inform you about the risks associated with using credit cards for medical payments. This crucial information helps you understand any potential implications of your payment choices.

Additionally, healthcare providers are now prohibited from assisting patients with applications for medical credit cards or third-party medical installment loans. They cannot arrange for or establish an application that you have not completely filled out yourself. This provision ensures that you pursue financial arrangements independently, free from any perceived influence from your healthcare provider. This measure reinforces your autonomy in managing medical expenses.

Understanding the Current Status of the Law

While New York State Public Health Law Section 18-c had an effective date of October 20, 2024, its implementation has been subject to review. The New York State Department of Health (DOH) has been reviewing the implementation of the law. This decision came after numerous concerns were raised by stakeholders in the medical community.

The DOH has indicated that it is reviewing the enforcement of Public Health Law Section 18-c until further guidance is issued. Providers, including the Medical Society of the State of New York (MSSNY), highlighted potential operational challenges. They expressed concerns that requiring payment consent only after services are rendered could disrupt typical healthcare workflows. There were also questions about potential conflicts with federal laws, such as the No Surprises Act.

The state’s Fiscal Year 2026 Executive Budget includes proposed revisions to the law. These revisions aim to address some of the concerns raised. Specifically, the proposed changes would remove the requirement that payment consent must be obtained after you receive healthcare services. Instead, consent could be given before services, provided that treatment costs have been thoroughly discussed. The revisions would also clarify that these consent-to-payment requirements apply specifically to non-emergency healthcare services.

As a patient, it is important to stay informed about these developments. While the core intent of the law, to provide greater transparency and control, remains, the practical application is under review. We will continue to monitor any updates from the DOH and the state legislature. These discussions are ongoing, and adjustments may still occur before the budget is finalized.

Your Broader Rights as a New York Patient

New York has a strong commitment to protecting patients, and Public Health Law Section 18-c is one piece of a larger framework. For example, New York law includes significant protections against surprise medical bills. Under the federal No Surprises Act, which became effective January 1, 2022, healthcare providers and facilities generally cannot bill you for more than your in-network co-payment, co-insurance, or deductible for certain surprise bills. This applies when you unexpectedly receive care from out-of-network hospitals, doctors, or other providers you did not choose, under specific circumstances.

Also, New York offers robust protections regarding medical debt. Medical debt cannot be reported to credit agencies and cannot affect your credit score in New York State. This provision removes a major source of financial pressure for many individuals and families. Hospitals and other providers also have a statute of limitations of up to three years to pursue collection of unpaid medical debt. After this period, they can no longer take legal action to collect.

You also have the right to receive an itemized bill and an explanation of all charges. Hospitals must provide a list of their standard charges for items and services, along with the health plans they participate with. If you believe you have received an unexpected bill, you have the right to challenge these charges through an Independent Dispute Resolution process. These rights, combined with the intent of Public Health Law Section 18-c, are designed to give you more power and understanding in your healthcare journey.

What to Do If You Have Questions or Concerns

Understanding your rights and navigating complex medical billing can be challenging. If you have questions about your medical bills, consent forms, or any aspect of your healthcare costs, do not hesitate to seek clarification. First, speak directly with your healthcare provider or the hospital’s billing department. Many facilities have patient representatives specifically trained to help resolve your concerns.

If you are not satisfied with the response, or if you feel your rights have been violated, you can contact the New York State Department of Health. They operate a Hospital Complaint Line at 800-804-5447. You can also complete and file a Facility Complaint Form online through their website. Additionally, the New York State Attorney General’s office provides information and resources regarding surprise medical billing and other consumer protections.

Remember, you have a right to understand all information related to your diagnosis, treatment, and prognosis. You also have the right to receive all the information necessary to give informed consent for any proposed procedure or treatment. This includes understanding the possible risks and benefits. Taking these steps can help ensure your medical care aligns with your expectations and your financial well-being.

Moving Forward with Confidence

New York State Public Health Law Section 18-c, even with its current implementation pause, signals a clear commitment to patient empowerment. The goal is to ensure you, the patient, have a complete understanding of both your medical treatment and its financial implications before making commitments. We believe that informed patients are truly empowered patients. By understanding these laws and knowing where to turn for help, you can approach your healthcare decisions with greater confidence and peace of mind. We are here to help you navigate these important legal changes, ensuring your rights are protected every step of the way.

Sources

• U.S. Codes and Statutes, 2025 New York Laws :: U.S. Codes and Statutes :: Separate Patient Consent for Treatment and Payment for Health Care Services. :: 2025 New York Laws
• New York State Department of Health, Patients’ Bill of Rights for Hospitals
• New York State Attorney General, Surprise medical billing
• NYS Open Legislation, Public Health – The Laws of New York – NYS Open Legislation | NYSenate.gov