OAG Helped Thousands of New Yorkers Resolve Medical Billing Errors, Insurance Denials, and Coverage Problems
New York Attorney General Letitia James today released the Office of the Attorney General’s (OAG) 2025 Health Care Bureau Annual Report, detailing how the office helped thousands of New Yorkers resolve health care disputes, correct medical billing errors, and obtain necessary medical treatment. In 2025, OAG’s Health Care Helpline handled 4,890 complaints from New Yorkers and secured $1.53 million in restitution and savings by correcting billing mistakes, reversing wrongful insurance denials, and addressing unlawful business practices.
“Health care is complicated enough without families being forced to fight insurers for the care and coverage they are entitled to,” said Attorney General James. “My office’s Health Care Helpline helps New Yorkers cut through red tape, correct billing mistakes, and access the care they need. Whether someone is facing a surprise bill, a wrongful denial of coverage, or confusion about their benefits, my office is here to help.”
The Health Care Helpline serves as a direct resource for New Yorkers seeking help with medical bills, insurance claims, and access to care. In 2025, helpline advocates directly intervened in 3,279 complaints and helped thousands more by providing information or referrals to other agencies. In addition to resolving individual complaints, the report, “Real Solutions for New Yorkers,” highlights how consumer complaints help OAG identify broader systemic issues in the health care system and launch investigations when necessary.
In 2025, the most common categories of complaints to the Health Care Helpline were provider billing (42 percent), wrongful practices such as improper collections or refund issues (24 percent), claim-processing errors (13 percent), and health plan denials of coverage (10 percent). Other complaints involved obtaining or maintaining insurance coverage and access to prescription drugs.
Many of the complaints handled by the Health Care Helpline involve significant financial or medical consequences for patients. Highlights from the report include:
- The OAG helped secure approval for a life-saving double-lung transplant for a patient with Stage 4 lung cancer whose insurance company initially denied coverage because he had not been cancer-free for five years. As the patient only had one to three years left to live, meeting that requirement was impossible, and his doctors had approved an earlier transplant as part of a clinical trial. After an OAG advocate challenged the denial and highlighted flaws in the insurer’s reasoning, the company reversed its decision and approved the procedure.
- The OAG successfully convinced a health plan to reduce outstanding debt for a disabled Social Security recipient from $262,466 to $1,297 after her health plan wrongfully refused to cancel claims following retroactive Medicare coverage. The health plan had sent her bills to debt collectors, but after significant pressure from OAG, the plan agreed to reprocess the claims in accordance with Social Security Administration guidance.
- A New Yorker was left with a five-figure ambulance bill after her son had to be transferred to another hospital due to emergency surgery complications. An OAG advocate intervened and negotiated with the insurer to reduce the bill to just $100 for the consumer.
- A cancer patient needed an MRI after being diagnosed with lymphoma, but the test was rejected by her insurer. The consumer later learned that her online insurance account had been wrongfully closed, and her attempts to reopen it failed. The OAG contacted the insurance plan and successfully restored the consumer’s account, allowing the MRI to be scheduled.
- An OAG advocate recovered $4,287 in premiums that a consumer paid for a fake health plan that did not provide adequate coverage. After the consumer discovered the plan was fraudulent and was unable to cancel it herself, OAG intervened to secure a full refund.
- A consumer was saddled with a $79,721 surprise bill after her insurance company suddenly stopped paying for her son’s mental health treatment and sought reimbursement for prior payments. The OAG intervened to remind the insurer of its legal obligations and existing settlements with OAG, ultimately forcing the plan to repay the denied claims, plus interest.
New Yorkers can contact the Health Care Helpline through the online complaint form to report and resolve health care complaints ranging from simple billing errors to complex deceptive business practices. Consumers can also call 1-800-428-9071 to file 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 other health-related business should contact the helpline for assistance. Helpline advocates also work to ensure that any negative impacts from improper medical billing or insurance claims are removed from credit reports.
