Article

Pass-thru Charging Patients for PPE ok?

Provided by:  Jennifer Kirschenbaum, Esq.

October 22nd, 2020

 

Question:

Hi Jennifer,

Can I seek reimbursement from an insured patient’s insurance company or from the patient for the cost of PPE or Covid-19 related precautions (barriers, screens, etc.)?  

Thanks, 
Dr. P


Answer:

Nope.  Not to the extent you are a participating provider.  Effective August 5, 2020, the State of New York  implemented a mandate that providers participating with insurance companies should not charge insured patients any fees for PPE that exceed that  patient’s normal financial responsibility.  https://www.dfs.ny.gov/industry_guidance/circular_letters/cl2020_14.   NYS Department of Financial Services (DFS) issued this mandate after receiving numerous complaints from those being charged for PPE.  In relying on Insurance Law §§ 3217-a(a)(5) and 4324(a)(5) and Public Health Law § 4408(1)(e), DFS stated that the law “clearly require issuers to disclose the insured’s financial responsibility for covered services, including any other charges, and such disclosure should be made for medical and dental coverage.”  In addition DFS states, “A provider who participates with an issuer’s provider network has agreed to accept a reimbursement amount from the issuer for covered services, with the insured responsible for the cost-sharing set forth in the insured’s health or dental insurance policy or contract.  A participating provider should not charge the insured fees or other charges in addition to the insured’s financial responsibility for covered services.   


Looking for the KK Healthcare Exchange?  Click Here. 

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Looking for HIPAA and compliance forms?  
Click here to visit our website.
Have a question or comment for Jennifer?
Contact Jennifer at Jennifer@Kirschenbaumesq.com or  at (516) 747-6700 x. 302.
Interested in having Jennifer speak at an event or
at a residency/fellowship program?
Contact Jennifer directly at (516) 747-6700 x. 302 or at Jennifer@Kirschenbaumesq.com
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Pass-thru Charging Patients for PPE ok?-October 22,2020-Jennifer Kirschenbaum

Article

Pass-thru Charging Patients for PPE ok?

Provided by:  Jennifer Kirschenbaum, Esq.

October 22nd, 2020

 

Question:

Hi Jennifer,

Can I seek reimbursement from an insured patient’s insurance company or from the patient for the cost of PPE or Covid-19 related precautions (barriers, screens, etc.)?  

Thanks, 
Dr. P


Answer:

Nope.  Not to the extent you are a participating provider.  Effective August 5, 2020, the State of New York  implemented a mandate that providers participating with insurance companies should not charge insured patients any fees for PPE that exceed that  patient’s normal financial responsibility.  https://www.dfs.ny.gov/industry_guidance/circular_letters/cl2020_14.   NYS Department of Financial Services (DFS) issued this mandate after receiving numerous complaints from those being charged for PPE.  In relying on Insurance Law §§ 3217-a(a)(5) and 4324(a)(5) and Public Health Law § 4408(1)(e), DFS stated that the law “clearly require issuers to disclose the insured’s financial responsibility for covered services, including any other charges, and such disclosure should be made for medical and dental coverage.”  In addition DFS states, “A provider who participates with an issuer’s provider network has agreed to accept a reimbursement amount from the issuer for covered services, with the insured responsible for the cost-sharing set forth in the insured’s health or dental insurance policy or contract.  A participating provider should not charge the insured fees or other charges in addition to the insured’s financial responsibility for covered services.   


Looking for the KK Healthcare Exchange?  Click Here. 

MISSED OUR RECENT WEBINARS?  CLICK HERE ANYTIME!
Looking for HIPAA and compliance forms?  
Click here to visit our website.
Have a question or comment for Jennifer?
Contact Jennifer at Jennifer@Kirschenbaumesq.com or  at (516) 747-6700 x. 302.
Interested in having Jennifer speak at an event or
at a residency/fellowship program?
Contact Jennifer directly at (516) 747-6700 x. 302 or at Jennifer@Kirschenbaumesq.com
Click here to learn about
K&K's Prepaid Legal Audit/Investigation Defense Now!