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Cuomo announces expanded Coronavirus testing, forces waived insurance costs associated with it

During a briefing on the novel Coronavirus at his office in midtown Manhattan, Governor Andrew M. Cuomo announced the world-renowned Wadsworth Center — the research-intensive public health laboratory housed within the State Department of Health — is partnering with hospitals to expand surge testing capacity to 1,000 tests per day statewide for the novel coronavirus.

The Wadsworth Center will provide these hospitals with instructions on how to replicate the State’s test, as well as help them purchase some of the equipment necessary to develop and validate the test.

The Governor also announced the state will institute a new cleaning protocol at schools and in the public transportation system to help stop any potential spread of the virus.

This announcement follows the Food and Drug Administration’s approval for the Wadsworth Center to begin tests for the novel Coronavirus — the first non-CDC test that has been given approval by the FDA. The first confirmed case of the novel coronavirus in New York, a woman in her thirties, was done through the State’s Wadsworth testing lab.

“We have the best health-care system in the world, and we are leveraging that system to help contain any potential spread of the novel coronavirus in New York,” Governor Cuomo said. “We will expand testing so we can do 1,000 tests per day thanks to the State’s world-renowned Wadsworth Lab in partnership with hospitals. And we are instituting a new cleaning protocol at our schools, in our public transportation, and elsewhere to contain any potential spread. This isn’t our first rodeo – we are fully coordinated, we are fully mobilized, and we are fully prepared to deal with the situation as it develops.”

Last week the Governor announced he is requesting a $40 million appropriation for the New York State Department of Health to hire additional staff, procure equipment and any other resources necessary to respond to the potential novel coronavirus pandemic. The Governor will also propose legislation to clarify authority for governor to take certain statewide actions and measures in response to the novel coronavirus outbreak as needed. DOH is ALSO convening local health departments and hospitals statewide to review protocols, best practices and procedures to help ensure they are prepared to combat the spread of the novel coronavirus.

He also announced a new directive by the State Department of Financial Services requiring New York health insurers to waive cost sharing associated with testing for novel coronavirus including emergency room, urgent care and office visits.

New Yorkers receiving Medicaid coverage will not be expected to pay a co-pay for any testing related to COVID-19.

In addition, the State outlined a series of other actions that New York health insurers are required or advised to take, including keeping New Yorkers informed regarding available benefits; offering, where possible, telehealth medical advice and treatment; and preparing insurers to cover the costs if a COVID-19 immunization should become available.

“We have the best health-care system in the world, and we are leveraging that system including our state-of-the-art Wadsworth testing lab to help contain any potential spread of the novel coronavirus in New York,” Governor Cuomo said. “Containing this virus depends on us having the facts about who has it – and these measures will break down any barriers that could prevent New Yorkers from getting tested.”

In order to ensure that cost-sharing is not a barrier to testing for COVID-19, DFS will promulgate an emergency regulation that:

  1. Prohibits health insurers from imposing cost-sharing on an in-network provider office visit or urgent care center when the purpose of the visit is to be tested for COVID-19.
  2. Prohibits health insurers from imposing cost-sharing on an emergency room visit when the purpose of the visit is to be tested for COVID-19.

The State Department of Health will ensure New Yorkers receiving Medicaid coverage have their costs covered. New Yorkers enrolled in self-funded employer-based health insurance plans that are not regulated by New York State due to the Employee Retirement Income Security Act of 1974 (ERISA) should contact their employer to fully understand the scope of coverage.

In addition to covering the cost of testing, the guidance issued by DFS to health insurers regarding actions they should take in relation to the potential impact of COVID-19 on New York includes:

  • Keeping Consumers Informed: DFS is directing insurers to devote resources to inform consumers of available benefits, quickly respond to consumer inquiries, and consider revisions needed to streamline responses and benefits for consumers.
  • Providing Telehealth Medical Advice & Treatment: DFS is directing insurers to develop robust telehealth programs with their participating providers where appropriate, particularly for individuals who may have difficulty making an office visit and where a phone call with a medical professional can alleviate the need for a hospital visit.
  • Preparing Health System for Increased Cases: DFS is directing insurers to verify that their provider networks are adequately prepared to handle a potential increase in the need for health care services, including offering access to out-of-network services where appropriate and required, in the event more COVID-19 cases are diagnosed in New York. In addition, DFS is reminding insurers that lifetime or annual limits cannot be placed on in-patient care.

  • Covering Costs if Immunization Becomes Available: In the event an immunization becomes available for COVID-19, DFS is reminding insurers that they must cover the cost of vaccination for children under 19. For adults, DFS’s guidance states that all insurers should be prepared to cover the immunization immediately at no cost-sharing.
  • Expanding Access to Prescription Drugs: With reports of prescription drug shortages due to supply chain issues, DFS is directing insurers to provide insurance coverage for off-formulary prescription drugs if there is not a formulary drug available to treat the insured, through a formulary exceptions process as required by law.
  • Ensuring Emergency Care: DFS is reminding insurers that coverage for emergency services in hospital facilities is required at the in-network cost-sharing even if the hospital is out-of-network or overseas, and that no insurer may require a patient to seek preauthorization prior to seeking emergency care, including for ambulance service.
  • Surprise Medical Bills: DFS is directing insurers that they are required to hold harmless insureds who receive surprise medical bills for health care services, including those related to testing and treatment of COVID-19.