Important! Essential Worker Copay issues

July 31, 2020

First thing to report is that the NYS Council will be meeting with leads from the Department of Financial Services (DFS) on Tuesday afternoon to discuss the letters many providers have received from Beacon, Optum and Independent Health (so far) requiring them to take extraordinary steps to comply with new billing requirements the plans are trying to put in play in order for providers to collect co-pays the provider has waived.      Diane Novy from the Jewish Board (Diane raised this issue on our Billing Geeks call this past Wednesday) will be joining me to provide state officials with very detailed information as to the numerous steps providers would have to take in order to comply with the process the plans are trying to saddle providers with.  

Next, The NYS Council is on it!

We sent the following question to our colleagues at DFS today: Q:  Is the mandate on insurers to waive copays for BH and other healthcare services (face to face and telehealth) provided to essential workers going to be extended today or very soon?  I ask because the DFS Circular #10 dated 5/2 that established the co-pay waiver states that the corresponding Emergency Reg is effective for 90 days.  By our calculations, we are just about at the 90 day mark.

A:  We received the following response from DFS leads today:

The emergency regulation to which you refer was re-filed yesterday and it is extended through September 28, 2020.  If you would like to review the regulation, you can access it on our website at

As always, if you have any questions please reach out to me at your convenience at 518-461-8200.