Overview
NY Public Health Law (PHL) § 18-c, regarding consent for payment of certain medical services, was enacted as part of the 2025 New York State budget. As drafted, it requires patient consent to payment for treatment costs. The New York State Department of Health (NYSDOH) is not currently enforcing the statute, however, pending additional guidance. Despite proposed legislative changes, the statute remains unchanged in 2025, and any changes are very unlikely until the next legislative session, which begins in 2026.
Earlier this year, the 2026 New York State budget included proposed changes to NY PHL § 18-c. Those provisions, however, were removed from the final version of the budget, leaving NY PHL § 18-c unaltered. A standalone bill to amend (A06773) was introduced and later amended significantly from its original form. A06773 would have introduced significant changes to NY PHL § 18-c that reflected provider feedback on the current iteration of NY PHL § 18-c. The bill was not brought to a floor vote before the end of the legislative session, however.
Legislative update
A06773 proposed to:
- Remove the requirement that consent for payment of certain medical services be obtained after the services are administered.
- Require the superintendent of financial services and the commissioner of health to develop a uniform consent form.
- Allow patients to request a “good faith estimate” of the cost of services to be provided during the patient visit.
Despite the failure to modify NY PHL § 18-c, NYSDOH has not issued any update to its previous guidance on the enforcement of it as the statute.
In Depth
NY PHL § 18-c provides that a patient’s consent to pay for healthcare services must be obtained separately from the informed consent for such healthcare services, and that consent to payment may only be obtained after the patient has received the applicable services and discussed treatment costs. Although NY PHL § 18-c was effective October 20, 2024, the next day the Medical Society of the State of New York (MSSNY) announced that it had received a copy of guidance that NYSDOH issued to hospital CEOs indicating that implementation of the consent-related requirements was on hold pending further guidance. To date, no guidance or regulations have been issued or proposed on how to implement the law, and significant ambiguities remain.
The MSSNY, several medical specialty organizations, and other stakeholders raised concerns regarding the logistical and operational challenges of requiring that consent to payment be obtained after healthcare services are rendered. Stakeholders noted that obtaining consent to payment after services are rendered is inconsistent with typical medical practice workflows, where consents and necessary paperwork are completed upon arrival. Stakeholders also raised concerns about whether a patient could receive services and then simply refuse to consent to payment.
There were multiple attempts in the 2025 New York legislative session to address those concerns through changes to the statute. The executive budget initial draft would have removed the requirement that the consent to payment be obtained after the patient received the applicable services (i.e., only discussion of treatment costs must occur before consent to payment is obtained). The proposed revisions also would have clarified that the restriction is applicable only to nonemergency healthcare services. As discussed above, A06773 similarly would have clarified that consent could be obtained prior to rendering the services and would have placed the consent on a uniform document that likely would have removed ambiguity regarding the consent requirements. No changes are expected, however, prior to 2026.
Next steps
We will continue to monitor and track any updates to New York patient consent requirements, including any changes to the enforcement landscape. Please contact the authors of this article or your regular McDermott lawyer with any questions.
