DFS Adopts Telehealth Reg for Audio-Only Coverage

December 22, 2021

The Notice (linked below) issued by the Department of Financial Services (DFS) appeared in today’s NY State Register.

In summary, DFS is now permanently requiring all state regulated insurers to cover audio-only telehealth services, when medically necessary.

Attached is the original regulation from September 22, 2021 which they are making permanent.  Many thanks to Marcy Savage at Reid, McNally and Savage for making an otherwise complicated Notice simple.  Now we just have to make sure the rates BH providers are reimbursed for audio-only services remain on par with reimbursement for face-to-face services.

See below and attached.

In 12/22/21 NY State Register:https://dos.ny.gov/system/files/documents/2021/12/122221.pdf

Minimum Standards for Form, Content, and Sale of Health Insurance, Including Standards of Full and Fair Disclosure
I.D. No. DFS-38-21-00004-A Filing No. 1221
Filing Date: 2021-12-06 Effective Date: 2021-12-22

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:

Action taken: Addition of sections 52.17(d) and 52.18(h) to Title 11 NYCRR.
Statutory authority: Financial Services Law, sections 202, 302; Insurance Law, sections 301, 3216, 3217, 3217-h, 3221, 4303 and 4306-g
Subject: Minimum Standards for Form, Content, and Sale of Health Insurance, Including Standards of Full and Fair Disclosure.
Purpose: To clarify application of Insurance Law Sections 3217-h and 4306-g.
Text or summary was published in the September 22, 2021 issue of the Register, I.D. No. DFS-38-21-00004-P.Final rule as compared with last published rule: No changes.

Text of rule and any required statements and analyses may be obtained from: Tobias Len, Department of Financial Services, One Commerce Plaza, Albany, NY 12257, (518) 474-8975, email: Tobias.Len@dfs.ny.gov Initial Review of Rule

As a rule that requires a RFA, RAFA or JIS, this rule will be initially reviewed in the calendar year 2024, which is no later than the 3rd year after the year in which this rule is being adopted.

Assessment of Public Comment
The New York State Department of Financial Services (“Department”) received comments from numerous health care providers across the State. All of the comments supported the proposed regulation; no changes were requested and no concerns were raised.

Health care providers commented that telehealth plays a significant role in providing quality care to persons who need mental health services and when clinically appropriate, an audio-only visit, such as by telephone, provides essential access to care to the people of New York.

The Department received additional comments indicating that audio- only visits will expand the reach of mental health services and access to care, particularly for specific populations, such as the elderly who are not able to use video-enabled technology. The comments stated that it is essential for insureds to continue to have access to health care services through audio-only telehealth visits.