“Hospitals continue to be on the front lines during this state of emergency and are stretched financially and administratively,” Linda Lacewell, DFS superintendent, said in a statement. “This directive will help provide much-needed cash flow to hospitals at a critical time in our fight against COVID-19.” The letter orders New York-regulated health insurers to “immediately” […]
“Hospitals continue to be on the front lines during this state of emergency and are stretched financially and administratively,” Linda Lacewell, DFS superintendent, said in a statement. “This directive will help provide much-needed cash flow to hospitals at a critical time in our fight against COVID-19.”
The letter orders New York-regulated health insurers to “immediately” process for payment outstanding hospital claims.
In addition, in collaboration with DFS, the insurers should work with hospitals in their networks to provide additional financial assistance “if needed and feasible,” focusing on “community, rural, and safety-net hospitals.”
DFS also directs health insurers to suspend preauthorization requirements for all services performed at hospitals, including lab work and radiology, until June 18 of this year, and not conduct retrospective reviews of hospital claims until June 18, “subject to limited exceptions.”
The department also orders insurers to not make medical-necessity denials related to emergency-department and inpatient hospital treatment for COVID-19.
“This directive will ease the financial burdens facing many hospitals throughout the state, especially community, rural, and safety-net hospitals, as they struggle to respond to the COVID-19 pandemic,” Dr. Howard Zucker, commissioner of the New York State Department of Health, said. “Hospitals are on the frontlines in the battle against COVID-19. This directive will help ensure they have the resources they need to continue to fight.”
“Severe financial stress”
Many hospitals are under “severe financial stress” due to the suspension of elective surgical procedures and increased costs resulting from COVID-19, DFS said.
During this “time of emergency, it is in the public interest for all stakeholders” to support hospitals, “particularly community, rural, and safety-net hospitals,” to ensure that patients continue to get the care that they need. “Recognizing the importance” of protecting the public and of maintaining the financial stability of hospitals, the health-insurance industry has “stepped up and worked closely with DFS to provide necessary relief” to hospitals during this crisis.
DFS worked with the Healthcare Association of New York State (HANYS), Greater New York Hospital Association (GNYHA), New York Health Plan Association (NYHPA), and the New York State Conference of Blue Cross and Blue Shield Plans (NYSCOP), the department said.
“We appreciate DFS taking this strong action to eliminate administrative barriers to care for all hospital-based treatment during this crisis. Furthermore, requiring plans to infuse cash through expedited payment of monies owed and to work with hospitals to provide additional financial assistance is the right thing to do, and an important step toward hospitals being able to continue providing care during this crisis,” Bea Grause, president of HANYS, said.