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N.Y. institutes policy cancellation, health coverage relaxations

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New York State is offering Storm Sandy relief for consumers in about 10 counties through its insurance and banking regulatory authority to impose a moratorium for 30 days or until further notice, prohibiting termination, cancellation or non-renewal of any “covered policy” under insurance law, along with other easements for consumers.

In an order amended November 5 and in effect back to Oct. 26, Ben Lawsky, Superintendent of Financial Services for the state, suspended certain provisions of insurance and banking law in the affected counties. New York, Bronx, Kings, Richmond, Queens, Nassau, Suffolk, Westchester, Rockland and Orange suffered the greatest damage and are the designated counties.

With regard to insurance, Lawsky also lifted any automatic policy renewal provisions within a covered policy during the moratorium but noted a policyholder could voluntarily terminate a policy during the moratorium.

Lawsky also issued insurance-specific guidelines that, in effect, tell health insurers that they 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,” the guidelines state. They were issued before the storm hit but remain in effect, according to a Department of Financial Services (DFS) spokesman. Another storm is expected to hit the area midweek and the “state of emergency” remains in effect regardless. The main DFS offices themselves on State Street and Beaver Street, close to the waterfront in lower Manhattan flooded and remain without power. Employees are working remotely or in other designated locations.

Health insurers should also relax limitations on prescription refills so that persons needing to get prescriptions filled in advance of the impending noreaster or at non participating pharmacies during and right after the storm will have access to their medicines, the DFS told insurers.

Insurers also should maintain call-in access 24 hours a day, seven days a week until the state of emergency has ended.

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 the availability of urgent care centers in order to avoid excessive use of the emergency room, the DFS Stated.

Insurers also had to provide contact information to the DFS for key operational employees. 

Likewise, New Jersey’s Gov. Chris Christie signed an executive order Nov. 2 which, among other things, directed insurers and other regulated entities to exercise appropriate forbearances on collection and cancellation activities, to relax documentation and other requirements, and to reduce insurance burdens on healthcare providers and patients.

For example, the order directs the easing of insurer requirements for notifications of hospital admissions; prior authorization requirements; and limitations on prescription refills. It also directs insurers to be flexible on due dates for claim filings and premium payments; and lenders to be flexible on due dates for loan payments, and on late fees.  

Christie also is prohibiting hurricane deductibles, as New York did, as well as other promulgations.


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