July 21, 2021
An Emergency Rule Making was published today in the New York State Register by the Department of Financial Services (DFS) to clarify post COVID-19 emergency, that an audio-only visit falls within the meaning of telehealth. Additionally, this amendment clarifies that for the purposes of telehealth, an insurer may engage in reasonable fraud, waste, and abuse detection efforts, including efforts to prevent payments for services that do not warrant a separate billable encounter. The rule states that this amendment is not intended to require coverage of services for which no charge is normally made consistent with existing regulations. The Department of Financial Services states that it expects every health care plan to reimburse a provider offering telehealth services for audio-only visits when medically necessary.
Essentially, this would make state regulated insurance coverage of audio only visits under telehealth permanent when medically necessary. The rule is now in effect and would need to be extended or adopted after October 3, 2021, the date it expires.
Many thanks to our fabulous government relations consultant Marcy Savage from Reid, McNally and Savage for spotting the Emergency Rule, passing it along to us, (and translating it too)!