The New York State Department of Financial Services (DFS) today issued a circular letter stating New York State health insurers must provide coverage of coronavirus (COVID-19) infection and antibody tests ordered and provided by a pharmacist without cost-sharing.
“As underscored by the Governor, we must expand the scope of testing for COVID-19 as we continue through this global pandemic,” said Superintendent Linda A. Lacewell. “DFS’ circular letter allows pharmacists to take samples and direct lab tests without imposing costs on New York consumers, covered by commercial insurance.”
In order to increase access to COVID-19 testing for all New Yorkers, Governor Cuomo issued Executive Order 202.24 (“EO 202.24”) on April 25, 2020, authorizing licensed pharmacists to order and administer COVID-19 tests that have been approved by the Food and Drug Administration (“FDA”) to detect a COVID-19 infection or its antibodies.
Governor Cuomo also announced the launch of a new pilot program with 52 independent pharmacies to conduct 7,000 tests per week. New York State now has more than 750 testing sites across the state. The Governor also encourages eligible New Yorkers to visit coronavirus.health.ny.gov to find a nearby testing site and get tested.
The DFS circular letter is consistent with Governor Cuomo’s EO 202.24, the federal CARES Act, and the DFS 57th Amendment to 11 NYCRR 52.
Health insurers are reminded that diagnostic testing, including laboratory tests, is an essential health benefit, and as such, must be covered under individual and small group comprehensive health insurance policies and contracts. New York Insurance Laws also require health insurers of large group comprehensive health insurance policies and contracts to make available coverage for laboratory tests, and such tests are typically covered in the base policy or contract.
Read a copy of DFS’ circular letter on the DFS website.
For additional DFS regulatory actions on the COVID-19 pandemic, visit www.dfs.ny.gov/industry/coronavirus.