The state is also encouraging insurers to develop and promote
strong telehealth programs.
New York state is drafting its health insurers
into the fight to contain the virus that causes Covid-19 pneumonia.
New York state will be requiring health
insurers, and Medicaid plans, to cover testing for severe acute respiratory
syndrome coronavirus 2, or SARS-CoV-2, by in-network medical offices without
imposing deductibles, co-payments or other cost-sharing requirements, officials
announced Monday.
Resources
·
An
article about the National Association of Insurance Commissioners’ new
pandemic risk primer is available here.
The ban on Covid-19 cost-sharing bills applies
to patients who get tested at in-network urgent care centers and in hospital
emergency rooms as well as at ordinary doctors’ offices and clinics.
The state is also asking insurers to:
·
Remember that state
law requires insurers to cover emergency services at all hospitals at the
in-network cost-sharing level, without imposing preauthorization requirements.
·
Shield enrollees
against “surprise medical bills” related to Covid-19 testing and treatment.
·
Develop strong
telehealth programs, especially for individuals who may have trouble visiting
a doctor’s office, and keep consumers informed about those programs.
·
Work with providers to
maximize provider networks’ ability to handle a dramatic increase in the number
of cases.
·
Prepare to cover
Covid-19 vaccination costs with no cost-sharing requirements, if and when a
vaccination becomes available.
·
Prepare to adjust drug
plan formularies, or covered drug lists, if the Covid-19 outbreak leads to
shortages of certain drugs.
The New York State Department of Financial
Services will be implementing the requirements by promulgating an emergency
regulation, officials said.
Officials noted that they cannot apply the
requirements to the self-funded employer health plans governed by the Employee
Retirement Income Security Act of 1974.
Enrollees in self-funded plans ”should contact
their employer to fully understand the scope of coverage,” officials said.
New York state has reported residents having
two confirmed cases of the SARS-CoV-2 virus.
The first case, which was announced Monday,
involves a 39-year-old woman who traveled to Iran, returned to her apartment in
New York City and was described as having symptoms of a mild respiratory
illness.
The second case, which was announced today,
involves a 50-year-old man who traveled to Miami, but not out of the country.
Officials reported that he had sought care in a hospital and is still in the
hospital. New York City Mayor Bill de Blasio said the man is in serious
condition.
New York State Gov. Andrew Cuomo said in a
comment included in the announcement of the new measures that the requirements
are necessary to the outbreak control effort.
“Containing this virus depends on us having the facts about
who has it,” Cuomo said in the comment. “These measures will break down any
barriers that could prevent New Yorkers from getting tested.”
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