States Start Requiring Insurers To Cover Coronavirus Care

New York regulators adopted a new emergency regulation requiring New York State insurance companies to waive cost-sharing, including, deductibles, copayments, or coinsurance for in-network telehealth visits.

The action by the Department of Financial Services makes New York the latest state to ease regulations as coronavirus sanctions and quarantines take effect across the United States.

The new regulation follows Gov. Andrew Cuomo’s announcement on Saturday that DFS will require insurance companies to waive co-pays for telehealth visits, whether or not related to coronavirus.

This 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 healthcare system and preventing further spread of COVID-19 or any other virus, the state explained in a news release.

“Today’s adopted regulation instructs insurance companies to provide telehealth services at zero cost for New York consumers," said DFS Superintendent Linda A. Lacewell. "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.”

Telehealth is the use of electronic information and communication technologies by a health care provider to deliver health care services to an insured while an insured is located at a site that is different from the site where the health care provider is located.

Following DFS’ regulatory action, state health agencies released respective guidance letters for consistent regulatory requirements for telehealth services to ensure that there are no regulatory barriers to telehealth visits for the insured and providers.

'A Significant Factor'

Delaware Insurance Commissioner Trinidad Navarro notified insurers last week of new rules related to COVID-19. In a bulletin, health insurers were told that testing for COVID-19 is a covered essential health benefit and that access to telehealth and telemedicine services should be made available.

“Concerns around the cost of care for coronavirus may be a significant factor in residents deciding not to seek out medical interventions when symptoms arise, leading to negative health impacts on the individual, and an increased possibility of the spread of the virus,” Navarro said. “Ensuring testing and expanding telemed options may be the biggest thing we can do to prevent the escalation of new transmissions.”

The bulletin notes that some insurers have taken additional steps to meet the challenges posed by the virus, including waiving cost sharing.

“I applaud those carriers who have committed to waiving upfront costs for their consumers. Residents may avoid being tested simply because they can’t afford to pay their co-pays or deductibles, and I commend the companies that are taking the barrier of economic ability out of the equation,” Navarro said.

In addition to ensuring COVID-19 testing is covered, whether at a testing facility or in emergency care, the bulletin also explains options surrounding telehealth and telemedicine and clarifies that healthcare providers can utilize webcam and facetime with their clients.

The bulletin specifies that care related to COVID-19 outside of the testing process should be considered in-network by health insurers if their in-network providers are unable to provide care in a timely fashion, in a safe and convenient location, or if they do not have trained, experienced providers of related care in-network.

The department made clear that immunizations for COVID-19, if made available, should be covered by insurers, as would related prescription drugs. The bulletin also reminds insurers that Delaware law prohibits surprise billing.

InsuranceNewsNet Senior Editor John Hilton has covered business and other beats in more than 20 years of daily journalism. John may be reached at [email protected]. Follow him on Twitter @INNJohnH.