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Press Release

September 21, 2017

Contact: Richard Loconte, 212-709-1691

DFS TAKES ACTION TO ENSURE INFANTS AND TODDLERS WITH DISABILITIES RECEIVE BENEFITS FOR NEW YORK’S EARLY INTERVENTION PROGRAM

Insurers Must Provide Benefits Information to Allow the Efficient Administration of Vital Services

Financial Services Superintendent Maria T. Vullo today announced that the Department of Financial Services (DFS) is taking action to ensure that infants and toddlers participating in the New York State Early Intervention Program (EIP) receive vital health benefits.  EIP, which is administered by the New York State Department of Health, offers a variety of therapeutic and support services to eligible infants and toddlers with disabilities and their families, including: family education and counseling, home visits, and parent support groups, special instruction, speech pathology and audiology, occupational therapy, physical therapy, psychological services, service coordination, nursing services, nutrition services, social work services, vision services, and assistive technology devices and services.  Under New York’s EIP, health insurers must provide municipalities with information on accident and health insurance policy benefits for children participating in EIP within 15 days of a request, so that insurance coverage is obtained before public funds are utilized.

“New York’s children are entitled to full Early Intervention benefits and insurers must provide those benefits as part of the programs administered by municipalities so that covered children have full access to EIP services,” said Superintendent Vullo.  “DFS reminds insurers that they must provide this information to municipalities on a timely basis so that infants and toddlers receive the vital services they need.”

New York law requires that providers of evaluations and EIP services are required to seek payment for EIP services from all third-party payors, including insurers, prior to claiming payment from a municipality.  If a child participating in the EIP is also covered by an accident and health insurance policy, the municipality, or its designee, and an EIP provider have a right to reimbursement of EIP services that are also covered services under the child’s policy.  This right is limited to expenditures the municipality has paid for EIP services or for services the provider has furnished to a child covered by the policy.

Once an issuer receives a written notice and request for information, the issuer must provide the municipality and service coordinator with information on the extent to which benefits are available to the child covered under the policy within 15 days.  The service coordinator is then required to provide the information to the EIP provider assigned to provide services to the child.

A copy of the DFS guidance can be found here.

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