Emergency Preparedness Guidelines for Health Insurers and Managed Care Organizations (Hurricane Sandy)
In light of the upcoming Hurricane Sandy, the Department of Financial Services (DFS) requests that all health insurers to implement emergency planning procedures until the State of Emergency has ended. In addition, DFS requests the following procedures be implemented during the State of Emergency:
- Prior Authorization. Insurers should relax their prior authorization requirements for the provision of urgent services. Members should be allowed to seek urgent care from participating and non – participating providers, as necessary. Similarly, providers should not be required to request authorization to treat enrolled members for the provision of urgent services and should be reimbursed accordingly.
- Rx Refills. Insurers should also relax limitations on prescription refills so that persons needing to get prescriptions filled in advance of the storm or at non participating pharmacies during and right after the storm will have access to their medicines.
- Information on Services. Insurers should provide information to employers, insureds and providers via website, and maintain call-in access 24 hours a day / 7 days a week until the State of Emergency has ended. The number must be provided to the DFS as soon as possible, but no later than 5:00 pm on October 29, 2012. Send the information to Laura.Dillon@dfs.ny.gov phone contact is (518) 486 - 9105. The call center and website should provide information to members on where and how to obtain service, and to providers who have questions about treating patients who seek care. This should include information on availability of urgent care centers in order to avoid excessive use of the ER. Include any pertinent information on the insurer's website.
- Contact Information. Insurers should provide contact information to the Department for key operational employees who can be reached to address major operational or processing issues as they emerge. Send the information to Laura.Dillon@dfs.ny.gov (Telephone -- (518) 486 - 9105).
New York's health insurers will be the first responders to a public seeking assistance. Beyond that DFS is preparing to take calls from consumers and providers via its emergency hotline and normal channels beginning on Tuesday (10/30/12) beginning at 8:00AM. We will work with carriers to resolve any issues that arise including any attempts to take advantage of relaxed protocols. Any carriers that experience operational difficulties after the storm should contact Laura Dillon (Contact information shown above). DFS is ready to work with any carriers that experience difficulty meeting statutory or regulatory deadlines associated with processing claims.