January 29, 2021
GOVERNOR CUOMO REMINDS NEW YORKERS THEY ARE NOT RESPONSIBLE FOR PAYING PPE CHARGES FROM IN-NETWORK HEALTH CARE PROVIDERS
Health and Dental Insurers Must Ensure Consumers Are Not Charged PPE Fees by In-Network Providers
New Yorkers Wrongfully Charged for PPE by In-Network Providers Are Eligible for Refund
To date, Department of Financial Services Has Secured More Than $400K in Restitution
Governor Andrew M. Cuomo today reminded insured New Yorkers that they should not be charged for Personal Protective Equipment by in-network healthcare providers under their state-regulated health and dental insurance coverage. Pursuant to State Department of Financial Services guidance, insurers are required to make sure that consumers are not charged PPE-related fees by in-network providers. New Yorkers who have been wrongfully charged are eligible for refund from their insurer. To date, the Department has recovered a total of $414,727 of PPE-related charges for more than 14,000 consumers since the start of the pandemic.
"While we continue to fight the war on COVID, PPE remains a critical tool to keeping the infection rate down and keeping New Yorkers safe until we reach herd immunity," Governor Cuomo said. "COVID-19 has dealt a financial blow to far too many New Yorkers, and they should never be responsible for the cost of critical PPE in the middle of a pandemic, especially when seeing their regular health care providers. New York will continue putting in place comprehensive protections to help ensure consumers are not wrongfully charged PPE-related fees and will take aggressive action to help recover any supplemental fees incurred."
Superintendent of Financial Services Linda A. Lacewell said, "New Yorkers are already facing some of the worst financial hardships due to the pandemic. DFS issued the circular letter to insurers to make sure consumers are not responsible for fees that go beyond their financial obligation. As we move forward during these uncertain times, we appreciate the efforts insurers have made throughout this pandemic and encourage healthcare providers and insurers to continue to work together so patients receive the care they need without extra charges."
The guidance, issued August 5, 2020, recommended that insurers:
- Immediately notify their participating providers not to charge PPE fees and that insureds should be held harmless for these charges;
- Instruct providers to refund PPE fees to insured persons;
- Notify insured persons that they should not be charged for PPE fees and provide insureds with insurers' contact information to submit related complaints;
- Work with their providers to resolve issues relating to increased costs due to COVID-19, including PPE fees, so insured persons are held harmless for these fees, which may require that insurers request information from providers about whether insured persons were charged improper fees; and
- Work with their providers to ensure that refunds are provided to insured persons; and
- Within 90 days of the circular letter, report to DFS the amount of PPE fees charged to insureds, the number of insureds impacted, and a description of how refunds will be provided.
New Yorkers with complaints about an insurance policy can contact DFS at www.dfs.ny.gov/complaint or through the DFS Consumer Hotline at (212) 480-6400 or (518) 474-6600 (Monday through Friday, 8:30 AM to 4:30 PM).