DFS: Insurance firms must waive cost-sharing for in-network telehealth visits

New York insurance companies are now required to waive cost-sharing — including deductibles, copayments (copays), or coinsurance — for in-network telehealth visits.  The New York State Department of Financial Services (DFS) on March 20 announced it adopted the new emergency regulation under New York Insurance Law.  The new adopted emergency regulation follows Gov. Andrew Cuomo’s […]

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New York insurance companies are now required to waive cost-sharing — including deductibles, copayments (copays), or coinsurance — for in-network telehealth visits. 

The New York State Department of Financial Services (DFS) on March 20 announced it adopted the new emergency regulation under New York Insurance Law. 

The new adopted emergency regulation follows Gov. Andrew Cuomo’s March 14 announcement that DFS will require insurance companies to waive co-pays for telehealth visits, whether or not related to coronavirus (COVID-19). 

The new regulatory action “helps to encourage” New Yorkers to seek medical attention from their homes rather than visit a hospital or doctor’s office for health-care services that may be unrelated to COVID-19 — “ultimately reducing strain on the health-care system and preventing further spread of COVID-19 or any other virus.”

Following DFS regulatory action, state health agencies released respective guidance letters for “consistent regulatory requirements” for telehealth services to prevent regulatory barriers to telehealth visits for the insured customer and providers.

“[The] adopted regulation instructs insurance companies to provide telehealth services at zero cost for New York consumers,” Linda Lacewell, superintendent of financial services, said. “This not only applies for COVID-19, it applies for any other covered health care services including mental health and substance use disorder treatment needed by the consumer, ensuring access to quality, affordable care right in their own home.”

The adopted DFS emergency regulation for the waiver of cost-sharing of in-network telehealth services says that during the COVID-19 state of emergency, health insurers may not impose — and none of its customers shall be required to pay — copayments, coinsurance, or annual deductibles for a telehealth-delivered, in-network service otherwise covered under the policy.

The regulation also says insurers will provide written notification to their in-network providers that they won’t collect any deductible, copayment, or coinsurance in accordance with this subdivision.  

Eric Reinhardt

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