The coronavirus pandemic has presented employers, workers’ compensation insurers, and third-party administrators with unprecedented challenges—both from a regulatory and statutory standpoint and from the incidence of novel claims for alleged coronavirus-related injuries. Goldberg Segalla’s Workers’ Compensation team will continue to provide our client community with weekly updates containing news and informed analysis on issues critical to their business.
On March 30, 2020, New York Gov. Andrew Cuomo signed Executive Order 202.13, extending the period of workers’ compensation, disability, and family medical leave benefits if “financial hardship” was the result of COVID-19 for a 60-day moratorium period.
The extension has an immediate impact on cancellation, non-renewal or conditional of workers’ compensation insurance to individuals, small business, or group insurance plans that have holders that are individuals or small business.
Section 54 NYS WCL Subsection (5) allows for cancellation of termination only after such notice is filed with the chair and served on the employer. A letter of non-renewal must be sent 30 days prior to the end of a policy—together with a 30-day notice where renewal involves a significant increase in prior policy amounts.
Insurance carriers have been placed on notice of the 60-day moratorium and are subject to sanctions for non-compliance.
On April 1, 2020, the New York State Workers’ Compensation Board issued an advisement (Subject 046-1048) that providers should use email rather than fax for prior authorization requests. This amends Section 325-1.4 of Title 12 of the New York Code Rules and Regulations.
This advisement directs all health care providers to use the email address as the preferred means of designated contact for MG-1, MG-2, and C-4 AUTH requests.
It also instructs insurance carriers, self-insured employers, and TPAs to forward any current designated fax numbers to email.
The New York State Workers’ Compensation Board stated that Orders of the Chair (Form EC-325) will be issued based on failure to respond to prior authorization requests. Additionally, formulary requests should continue to utilize the portal method.
For more information or immediate guidance, contact: