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Ex. AGY-ST-INSURANCE-BANKING-004 Context (guidance or announcement) Primary source read

Insurance Circular Letter No. 8 (2020)

Coronavirus, Utilization Review, and Emergency Admission Notification Requirements

Superintendent of Financial Services · New York; Department of Financial Services (Sector regulator)

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The COVID Project
Context, not an order

This record is guidance or an announcement kept for context. It is not counted among the orders in force.

The record

Jurisdiction
New York; Department of Financial Services · New York
Level
Sector regulator
Authority
N.Y. Ins. Law art. 49 (utilization review) as applied during the Executive Order 202 emergency
Issued
2020-03-20 Mar. 20, 2020
Effective
2020-03-20
End
90 days from March 20, 2020 (June 18, 2020), subject to further evaluation; the suspension was renewed for the winter surge by Circular Letter 17 (2020) (Ex. 006) (read as 2020-06-30)
In force
Mar. 20, 2020 to June 30, 2020
Quarters
2020 Q2
Limitation types
Health care orders
Addressees
  • all accident and health insurers
  • Article 43 corporations
  • HMOs
  • student health plans
  • municipal cooperative health benefit plans
  • prepaid health services plans
  • utilization review agents
  • licensed independent adjusters
Functions reached
  • IN health insurers (utilization review function suspended)
  • CB payers of hospitals and surgeons (industry 01, 02): preauthorization and concurrent review suspended
  • OP
Character
context
Collection
State insurance and banking regulators AGY-ST-INSURANCE-BANKING

Operative words

should suspend preauthorization review for scheduled surgeries or admissions at hospitals for 90 days from the date of this letter, subject to further evaluation as the COVID-19 situation develops... should suspend concurrent review for inpatient hospital services provided for 90 days from the date of this letter, subject to further evaluation as the COVID-19 situation develops.

Enforcement

N.Y. Ins. Law § 109; utilization review agent registration (art. 49)

Notes

Issued as hospitals redeployed staff and 'with the suspension of non-time sensitive scheduled procedures.'

Retrieval note

Cite it as context and cite the underlying order, statute or emergency rule it describes as the instrument. (Bulletins whose operative text imposes a mandatory duty on licensees under the regulator's own authority are excluded from this downgrade and listed separately for review.)).

A record of The COVID Project. The instrument's text is the source's; the summary fields are The COVID Project's reading of it. Not legal advice.