Man hit with $650,000 in medical bills gets relief after CBS News story
Help is finally on the way for a Long Island man who got over $650,000 in medical bills after his insurance company denied coverage for his emergency back surgery. Oxford United Healthcare told CBS News on Wednesday it will now pay that claim and Frank Esposito will owe nothing besides his usual copays.
"I feel a little bit lighter. I won't feel as heavy. I won't have all that pressure on me and I'm looking forward to it," he said.
New York Governor Andrew Cuomo saw Esposito's story and told state officials to look into his case.
"I was shocked to watch the story on CBS News where Mr. Frank Esposito went to the hospital with back pain and left with a reported $650,000 in bills that his insurer did not fully cover. In New York State, no one should go bankrupt because they sought medical care," Cuomo said in a statement.
CBS News shared Esposito's story on Monday. After enduring back pain, an MRI showed a bulge in his spine. A specialist told him to go to the hospital and doctors at the emergency room said he needed surgery right away. Esposito said the herniation was so severe, it could cut his nerve and render him paralyzed.
While the surgery was a success, Esposito was hit with over $650,000 in medical bills. His insurance company said the surgery didn't qualify as an emergency. Esposito hired a company to negotiate down some of his bills. After appeals, Oxford United Healthcare did pay some of them, but he still owed $220,000.
Cuomo said he called on the New York State Department of Financial Services to fix the problem and he announced he's calling on DFS to issue regulatory guidance on surprise medical bills. The goal is to make sure patients are informed that they are protected from paying more than their normal co-pay if they receive a surprise bill.
"We also must act to further protect other New Yorkers facing scenarios similar to Mr. Esposito, and today I called on DFS to issue regulatory guidance to ensure insurance companies are properly notifying patients how they can seek relief from surprise medical bills," Cuomo said.
Esposito said he's grateful for the help, but said it "shouldn't be this difficult."
"I would really like to see a major revamp in our healthcare system. That people can afford to have insurance, that you can get the care you need when you need it. That you don't have to worry about what the price tag is," Esposito said.
In a new series, "Medical Price Roulette," CBS News is collaborating with journalists at ClearHealthCosts to bring transparency to health care markets. We'd like to know what you paid for medical procedures. Share your story and learn how you can search ClearHealthCosts' database of prices in our sample markets. You can also email us at healthcosts@cbsnews.com.
Governor Cuomo encourages any New Yorker who currently has an issue with surprise medical bills to file a complaint at www.dfs.ny.gov/complaint, or call DFS's hotline — 800-342-3736 (open between 8:30 a.m.-4:30 p.m.) or reach out to DFS's dedicated email: SurpriseMedicalBills@dfs.ny.gov.
