New York directs insurers to ‘immediately’ process outstanding hospital claims, suspend prior-auth

April 23, 2020

New York Gov. Andrew Cuomo announced yesterday that the state is directing health insurers to provide cash-flow relief and ease administrative requirements for New York hospitals during the ongoing COVID-19 response, according to a press release issued by the New York State Department of Financial Services. This includes directing insurers to immediately pay outstanding accounts receivables, as well as suspension of retrospective claims review and prior-authorization requirements.

DFS will issue a letter directing health insurers to:

  • Immediately process for payment outstanding hospital claims;
  • In collaboration with DFS, work with hospitals in insurers’ network to provide additional financial assistance if needed and feasible, focusing on community, rural, and safety-net hospitals;
  • Suspend preauthorization requirements for all services performed at hospitals, including lab work and radiology, until June 18, 2020;
  • Not conduct retrospective reviews of hospital claims, until June 18, 2020, subject to limited exceptions; and
  • Not make medical necessity denials related to emergency department and inpatient hospital treatment for COVID-19.

“The Department of Financial Services is going to issue a directive to health insurers to provide financial and administrative relief to our hospitals so they can continue safely and quickly providing the care that is so desperately needed right now,” Cuomo said in announcing the decision.

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