Coronavirus (COVID-19) Relief Center
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These resources – like the public health crisis itself – are constantly evolving and are only current as to the date of publication. This page was last updated on July 20, 2020.
We recommend that you monitor this site, as well as the sites referenced in these resources, for updates and changes as we expect the situation and solutions to change over the coming weeks and months. For information on specific programs, we encourage you to visit the websites of the organizations or government entities that are responsible for the relief.
Description of Program and Relief
DFS Advises Insurers to Suspend Pre-Authorization and Administrative Requirements
The New York State Department of Financial Services (DFS) issued guidance for insurers to suspend preauthorization and administrative requirements for hospitals in response to COVID-19. The suspension of these requirements will help hospitals meet increased demand for inpatient care and more efficiently discharge patients when medically appropriate, thereby freeing up hospital beds for COVID-19 patients.
Specifically, insurers should suspend the following requirements: (1) Pre-authorization review for scheduled surgeries or admissions at hospitals; (2) Concurrent review for inpatient hospital services provided; (3) Retrospective review for inpatient hospital services and emergency services provided at in-network hospitals; (4) Pre-authorization review for home health care services and inpatient rehabilitation services following an inpatient hospital admission; (5) To the extent currently required, pre-authorization review for inpatient rehabilitation services following an inpatient hospital admission for mental health and substance use disorders; (6) Deadlines for hospitals to submit an internal or external appeal for a medical necessity denial; and (7) Non-essential payment audits of hospitals and the timeframe for the insurer to recover overpayments.
Government or Lead Agency
NYS Department of Financial Services
Dates Available
March 20, 2020 for the next 90 days
List of Additional Information
© 2021 Paul, Weiss, Rifkind, Wharton & Garrison LLP. This does not constitute legal advice and does not create an attorney-client relationship. In some jurisdictions, this publication may be considered attorney advertising. Past representations are no guarantee of future outcomes.