Thank you front liners

Providing Financial Relief

The coronavirus crisis is creating financial hardships for many, including our members and providers. Accordingly, we have taken steps to alleviate some of the financial burden of the pandemic.

Relief for Members

  • The COVID-19 crisis has had an immeasurable impact on all New Yorkers, particularly those on the front lines, such as health care workers, first responders, and all employees deemed essential. As such, the Department of Financial Services (DFS) has issued an emergency regulation removing all cost-share for essential employees seeking outpatient behavioral health care services with in-network providers. Effective May 2, 2020, this regulation has recently been extended through April 26, 2021.

    To ensure eligible members receive these services at no out-of-pocket cost, DFS is asking that providers ask each patient if they are an essential worker before collecting copayment. For a list of employees considered essential, visit the NYS DFS website. In lieu of other guidance, we ask that the modifier CR (“catastrophic/disaster-related”) be used when submitting a claim.

    Cost-share for any medications subsequently prescribed will not be waived.

    The change affects all CDPHP commercial, Medicaid (although there is no cost-share for Medicaid), Child Health Plus, and Essential Plan members, as well as all self-funded ASO groups that have elected to waive cost-shares for essential employees. The change does not apply to CDPHP Medicare Advantage members or members of self-funded groups that did not choose to follow the mandate.

    Please note, the regulation does not apply to members enrolled in federally qualified health savings accounts (HSAs). For federally qualified plans that do not have an HSA, you must meet the deductible before CDPHP will waive any applicable co-insurance or copays.

    The emotional and psychological well-being of essential workers is critically important in the continuing fight against COVID-19. We thank you for your support.

  • CDPHP is waiving cost share for all coronavirus-related testing and treatment, as well as telemedicine services provided by in-network providers, until May 4, 2021.* 

Relief for Providers

The cancellation of elective surgeries, routine cancer screenings, and other medical services have reduced the volume of patient visits for many medical practices. Fortunately, most of our primary care partners are on global payments from CDPHP, which keep their reimbursements level. But for those anticipating fee-for-service payments, the current crisis could lead to a reduction in cash flow.

  • CDPHP is monitoring our network’s financial viability closely. If you believe your practice is financially imperiled, please contact your provider relations specialist.

  • Under the recently enacted CARES Act, there are a number of loan, grant, and advanced payment provisions. Pay particular attention to the Paycheck Protection Program and SBA loan provisions.

  • We strongly recommend that you register now for electronic fund transfer (EFT) with CDPHP if you haven’t already enrolled. EFT payments are automatically transferred to your bank account, minimizing the risk of a delayed payment that could potentially happen with a paper check. You can easily register by following this step-by-step guide or contacting your provider relations representative.

*Note: Some CDPHP members belong to self-funded (ASO) groups that have unique requirements for medical service coverage during the COVID-19 crisis. You can verify coverage by contacting our provider services department at (518) 641-3500 (Monday through Friday, 7:30 a.m. to 5 p.m.).