March 13, 2020
DFS ADOPTS EMERGENCY REGULATION DIRECTING HEALTH INSURERS TO WAIVE COST-SHARING FOR NOVEL CORONAVIRUS TESTING
DFS Emergency Regulation Prohibits Insurers From Imposing Cost-Sharing, Copayments, Coinsurance, or Annual Deductibles for Novel Coronavirus Diagnostic Testing
The Department of Financial Services today announced an emergency regulation that prohibits New York health insurers from imposing cost-sharing on emergency room visits, in-network outpatient provider office visits, in-network urgent care center visits, in-network telehealth visits, and in-network laboratory tests when the purpose of the visit or test is to diagnose novel coronavirus (COVID-19). This emergency regulation ensures that cost-sharing is not a barrier to testing for COVID-19 for New Yorkers.
“Under Governor Cuomo’s leadership, containing this virus and ensuring that our residents are protected is New York State’s top priority, and the best way to do that is by eliminating barriers to testing,” said Superintendent Linda A. Lacewell. “This emergency regulation will allow New Yorkers to get tested without worrying about cost, providing a measure of relief as the COVID-19 situation evolves.”
This emergency regulation also requires that insurers notify their in-network health care providers not to collect any deductible, copayment, or coinsurance for diagnostic testing for COVID-19.
This regulation follows guidance issued on March 2nd, 2020 that outlined a series of other actions that New York health insurers are required or advised to take, including keeping New Yorkers informed regarding available benefits; offering, where possible, telehealth medical advice and treatment; preparing insurers to cover the costs of a COVID-19 immunization should one become available; and guaranteeing access to out-of-network providers at the in-network cost-sharing when no in-network provider can treat the insured.
Copayments, coinsurance, or annual deductibles may be imposed in accordance with the applicable policy for any follow-up care or treatment for the novel coronavirus (COVID-19), including an inpatient hospital admission, as otherwise permitted by law.
The emergency regulation is issued under Sections 202 and 302 of the Financial Services Law and Sections 301, 3216, 3217, 3221, and 4303 of the Insurance Law.