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DFS to extend regulation requiring health insurers to waive copays for COVID-19 vaccine until April 30


Wed, Apr 7th 2021 06:20 pm

Circular letter issued by DFS to insurers is available here

Gov. Andrew Cuomo on Wednesday directed the Department of Financial Services to extend the emergency regulation requiring all health insurers to waive co-pays for the COVID-19 vaccine until April 30. The extension of this regulation and guidance will help to ensure there are no barriers to New Yorkers accessing the vaccine as the state continues to implement its vaccine administration plan and get every New Yorker vaccinated.

"We know the vaccine is the weapon that will win the war against COVID, and we are doing everything we can to get more shots in arms as quickly as possible and become the first COVID-free state in the nation," Cuomo said. "From the beginning of our vaccination efforts, we've prioritized vulnerable communities that have been hit the hardest by COVID, and extending this regulation will further break down barriers to access and help ensure that no New Yorker is denied a vaccine just because they can't afford it."

First issued Dec. 16, the regulation requires a policy or contract that provides hospital, surgical or medical care coverage, including a grandfathered health plan, to provide immediate coverage, without cost sharing, of COVID-19 immunizations and the administration thereof at a provider's office, facility, pharmacy or other setting, including any provider or location authorized by New York state or the federal government to administer or host the administration of the immunization.

The DFS also previously issued a circular letter to New York-regulated health insurers directing them to immediately cover, without cost-sharing, approved COVID-19 immunizations and their administration.

Superintendent Linda A. Lacewell said, "DFS has been at the forefront of this virus since the first case by providing financial regulatory relief to New Yorkers and businesses across the state. It is now more important than ever to get vaccinated as New York continues to rebuild, which is why DFS is extending the regulation to require New York health insurers to waive copays for the COVID-19 vaccine. We believe all New Yorkers should have access to vaccines without the financial burden of copays."

Federal rules also require COVID-19 immunizations and their administration to be covered when provided by out-of-network providers for the duration of the public health emergency. Health care providers that participate in the Center for Disease Control COVID-19 vaccination program must agree to administer a COVID-19 immunization regardless of an individual's ability to pay or health insurance coverage status, and may not seek reimbursement from the immunization recipient.

DFS expects full adherence to state and federal requirements for coverage of any approved COVID-19 immunization and its administration.

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