Per the notice below, the New York State Attorney General (NYSAG) has recovered more than $4.6 million for New Yorkers who had complaints against health insurers and health care providers.

Attorney General James’ Health Care Helpline Recovers More Than $4.6 Million in Restitution and Savings For New Yorkers

Free Helpline Handled More Than 4,800 Cases for New Yorkers with Health Care Complaints in 2023 and 2024

New York Attorney General Letitia James today released a report detailing the work of the Office of the Attorney General’s (OAG) Health Care Helpline, a free service that recovered more than $4.6 million in restitution and savings for New Yorkers in 2023 and 2024.  The Health Care Bureau’s (HCB) Helpline is staffed by a dedicated team of advocates who work with New Yorkers to resolve disputes with insurance companies, correct overbilling, and ensure they can access medically necessary care or prescription medication that they have been unfairly denied.  In 2023 and 2024, the Helpline handled more than 4,800 consumer complaints, reversing wrongfully rejected health insurance claims, correcting inaccurately processed claims, reinstating New Yorkers’ incorrectly terminated health coverage, and rectifying companies’ wrongful business practices.

“Every New Yorker deserves affordable, accessible health care and coverage,” said Attorney General James.  “Whether it’s recovering thousands of dollars in wrongful medical charges, ensuring access to life-saving treatments, or holding companies accountable for deceptive practices, my office is committed to fighting for New York patients and protecting their rights.  No one should have to battle insurance companies or medical providers alone.  I urge anyone who believes they were wrongfully billed or denied care or coverage to contact my office for support.”

The Health Care Bureau’s 2023-2024 Report, “Real Solutions for Real New Yorkers,” presents the work HCB and the Helpline have taken over the past two years to assist New Yorkers.  The report highlights actions taken by Helpline advocates to resolve consumer complaints, discusses major cases handled by the bureau, and details health care concerns facing New Yorkers.  In 2023 and 2024, Helpline staff handled 4,803 consumer complaints and provided another 2,010 consumers with information or referred them to an appropriate agency for assistance.  Complaints addressed through the helpline included:

• An individual with cancer was terminated from his job and, in the termination letter, his employer stated that his health insurance would expire at the end of the month.  Thinking he still had insurance, he continued to receive care through the end of the month but later learned that a broker had told his insurance company to terminate his coverage the day he was let go.  He contacted the helpline for assistance and an OAG advocate was able to work with the insurer to restore coverage for the remainder of the month, process the claims, and save the consumer nearly $11,000 in medical bills.
• A consumer experiencing homelessness was admitted to a hospital and, after proving he qualified for financial assistance, was told his care would be 100 percent covered by the hospital’s financial aid.  However, upon discharge, he started receiving bills for more than $1,000.  As the bills continued to come, the consumer attempted to contact the hospital for help but struggled with a language barrier.  After OAG intervened, the hospital reversed course and covered the individual’s entire bill using financial aid, erasing the consumer’s outstanding balance.
• A consumer was unable to use her power wheelchair due to a dead battery, but the vendor who makes the batteries refused to schedule a delivery.  Instead, the vendor was trying to force the consumer to travel to its office for installation — something she physically could not do.  The consumer contacted the helpline, and an OAG advocate successfully intervened, scheduling a battery delivery and installation for the following week.
• A consumer had to undergo emergency surgery after she went to the ER at the urging of her health plan’s telemedicine provider, who then directed her to the nearest hospital.  Her health plan initially declined to cover the emergency surgery, noting it was an out-of-network hospital and claiming that the surgery could have been an outpatient treatment.  The OAG directed the health plan and hospital to work together to facilitate a resolution and, ultimately, saved the consumer more than $50,000.
• A consumer contacted OAG after being billed more than $63,000 for an MRI, nearly $60,000 of which was for a single medication.  Upon investigation, OAG discovered that the provider had mistakenly billed for 150 units of medication instead of a single unit – and that the provider had done the same to nearly 60 other consumers.  The OAG secured refunds for patients wrongfully charged and put an end to the accidental overbilling.
• After a consumer complained that their birth control insurance claim was denied by UnitedHealthcare, OAG launched an investigation that ultimately resulted in a $1 million settlement with UnitedHealthcare and full reimbursements for all patients whose claims were denied.

In addition to highlighting the challenges faced by New York health care consumers, complaints handled by the HCB helpline are also an important ways to identify systemic problems in the state’s health care system.  While not all complaints and inquiries can be resolved favorably, the helpline is a crucial source of reliable and objective information for New Yorkers.  New Yorkers can contact the HCB helpline through the online complaint form to report and resolve health care complaints and concerns ranging from simple payment processing errors to complex deceptive business practices.  Consumers can also call the toll-free HCB helpline at 1-800-428-9071 to lodge a complaint.  Any consumer who believes that they may have been treated unfairly by a health care provider, Health Maintenance Organization (HMO), insurance plan, or health-related business should contact the helpline.  Helpline advocates also work to ensure that any negative effects from improper medical billing or insurance claims are removed from credit reports.

The Health Care Bureau is led by Bureau Chief Darsana Srinivasan and the Helpline is overseen by Assistant Attorney General/Helpline Manager Nannette Kelleher.  The Health Care Bureau is a part of the Division for Social Justice, which is led by Chief Deputy Attorney General Meghan Faux and overseen by First Deputy Attorney General Jennifer Levy.