The state has recovered millions for New Yorkers in disputes with insurance companies and providers over billing and claims denials through the attorney general’s health care help line.
The call line, which fields complaints and offers assistance on health-related concerns, received approximately 6,800 complaints from residents in 2023 and 2024, according to Attorney General Letitia James’ office. The resolved claims, which range from incorrect billing to insurance appeals, amounted to $4.6 million for New Yorkers.
The claims shed light on the byzantine and, at times, predatory processes for receiving and paying for health care. They come from some of the most vulnerable New Yorkers, including people who face housing and employment insecurity or language barriers that limit access to care and expose them to exploitation within the health system.
Many of the cases are, on their face, brazen and reveal some of the common practices that leave patients trampled underfoot with little recourse to often faceless corporate entities. Investigations initiated through a help line call often exposed systemic practices that impacted dozens or hundreds of other residents.
In one instance, a patient was billed more than $63,000 for an MRI, almost all of which was to cover 150 doses of a medication accompanying the scan. But the patient had received only one dose of the medicine. An attorney general’s office investigation revealed the provider had done the same to 59 other patients.
In another case, a cancer patient who was fired from their job was told by their employer that they would retain health coverage for a period of time only to discover that a broker had terminated their plan, leaving them on the hook for $11,000 in medical bills.
In a third case, a homeless person who had been admitted to a hospital was told they qualified for aid to receive services for free only to later be billed $1,200 by the hospital.
The latest numbers come in the wake of the killing of UnitedHealthcare CEO Brian Thompson in Midtown last fall, which set off a national debate about unethical practices within the insurance industry. They also come as the Trump administration takes steps to gut the Consumer Financial Protection Bureau, another entity that handles unscrupulous business practices. While the agency does not deal directly with health insurance, it does handle unfair medical debt collection. In January, before the start of President Donald Trump’s second term, the bureau finalized a rule to remove medical bills from credit reports.
The New York claims highlight practices by some of the biggest providers and insurers in the country.
Some of the recovered funds came from a settlement with UnitedHealthcare last June over denied birth control claims that violated state law. United agreed to pay $1 million in penalties and reimburse wrongfully denied customers after a patient in Brooklyn called the hotline over a rejected claim.
And Northwell Health, the state’s largest provider, was forced to refund $400,000 to customers and pay the state another $650,000 penalty for advertising some of its emergency departments as Covid testing sites, only to bill people for ER visits when they went in for tests. In some cases, customers received the bill after getting a test at a drive-through location.
Of the complaints, the attorney general’s office handled about 4,800 directly and referred another roughly 2,000 individuals to other entities or provided information on their cases. About half of the complaints involved a provider incorrectly billing patients.
