New York To Require Insurers to Waive Covid-19 Test Cost-Sharing

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

• A copy of the New York state announcement is available here.
• 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.