COVID-19: An important message for our policyholders

As our thousands of New York physicians, nurses, dentists, allied professionals, facilities, and dedicated health care teams engage the coronavirus COVID-19 on the front line, we want to reassure you that MLMIC Insurance Company stands with you. Our top priority is to do everything we can to support you.

Watch a replay of the NYS Department of Health’s webinar: A COVID-19 Update for Healthcare Providers, recorded on 3/26.

Read the FAQs

MLMIC’s toll free 24/7 Legal Hotline – (855) FAKS-LAW (1-855-325-7529) can help address many questions or concerns that may arise.

Our staff remains directly available via phone (800) ASK-MLMIC (1-800-275-6564) and every effort will be made to handle inquiries and answer questions regarding claims, coverages and policies on an immediate basis.

Questions about COVID-19? Call the New York State Coronavirus Hotline: 1-888-364-3065. Or, contact the New York State Department of Health: Covidproviderinfo@health.ny.gov

For those policyholders who face changes in their practice due to the negative impact wrought by COVID, MLMIC has options to be of assistance. Learn more.

 

COVID-19 Disruptions and Financial Hardship

As MLMIC continues to work in support of our policyholders, and to alleviate some of the adverse impact caused by COVID-19, premium installment due dates and potential policy cancellations due to non-payment of premium can be adjusted if your practice is encountering a demonstrated financial hardship due to COVID-19. To discuss these forms of potential accommodation, please contact us at (800) ASK-MLMIC (1-800-275-6564).

Executive Orders issued by the Governor of New York State

Executive orders are a method for the state government to ensure all actions can be taken to respond effectively and efficiently to a state emergency without being impeded by state laws and regulations that ordinarily serve a purpose but during the emergency can often hinder the fastest and best response to an emergency. The executive order accomplishes this goal by suspending or modifying certain laws or regulations that are listed in the order.

Executive Order 202

This Executive Order suspended or modified a variety of New York Education Law and Public Health Law provisions in order to accomplish the following:

  • Allow unlicensed persons to, upon training, collect swab specimens from persons suspected of having COVID-19.
  • Authorized the New York State Department of Health to enact emergency rules and regulations to, among other things, permit hospitals to most effectively prepare for, and treat, the influx of persons seriously infected with COVID-19.
Read the full executive order
Executive Order 202.1

This Executive Order suspends various laws and regulations in order to permit expansion of services and temporary facilities for health and human service providers. Also, the order suspended laws and regulations relating to child care to allow flexibility for providers while continuing to protect children’s health and safety.

Read the full executive order
Executive Order 202.2

This Executive Order concerned suspension and modification of law governing elections in New York State. It also imposed certain requirements on school districts closing due to a local state of emergency.

Read the full executive order
Executive Order 202.3

This Executive Order limited gatherings in any one location to no more than 50 persons. The Order also required food service establishments to no longer serve food on premises but only via delivery or pick up and it closed all gyms, fitness centers and movie theaters in the state.

Read the full executive order
Executive Order 202.4

This Executive Order directed local and state employees whose position is non-essential to either work from home or take leave. In addition, the Order mandated closure of all New York State schools until April 1.

Read the full executive order
Executive Order 202.5

This executive order contains numerous suspensions and modifications of New York laws and regulations. Among those of particular note are the following:

  • Allows physicians, physician assistants, and nurses licensed anywhere in the U.S. to practice medicine in New York State.
  • Allows NY licensed but not registered physicians to practice medicine in New York State.
  • Allows hospital staff who are privileged and credentialed to work in a hospital or health care facility in another state to practice in a hospital or health care facility in New York State.
Read the full executive order
Executive Order 202.6

This executive order primarily mandates that most New York businesses reduce their in-office workforce by 50 percent. The order makes an exception for essential businesses providing essential services. The following is a list of essential health care operations:

  • Research and laboratory services
  • Hospitals
  • Walk-in-care health facilities
  • Veterinary and animal health services
  • Elder care
  • Medical wholesale and distribution
  • Home health care workers or aides
  • Doctor and dentist offices
  • Nursing homes, or residential health care facilities or congregate care facilities
  • Medical supplies and equipment providers
Read the full executive order

FAQs in the age of COVID-19

  • Is Telemedicine covered under my MLMIC Professional Liability Policy?

    Yes, MLMIC will cover you for potential claims arising from medical services delivered using telemedicine subject to the terms, conditions, and exclusions of your policy if:

    • You are licensed in the state where the patient is being treated.
      • This includes states with licensure reciprocity with New York;
      • The temporary waiver of requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state (this applies to both Medicare and Medicaid); and
      • Any future Federal regulation that will allow doctors and other medical professionals to practice across state lines, even if they are not licensed to practice in a particular state;
    • You are practicing within the scope and specialty listed on your declaration page.
    If you have additional questions regarding coverage, please contact MLMIC Underwriting at (800) ASK-MLMIC (1-800-275-6564).

  • Is telemedicine exempt from privacy laws such as HIPAA and the NYS Public Health Law?

    No. Federal and State privacy law still apply to medical services delivered by telemedicine. The Coronavirus Appropriations Act does not contain any exemptions for HIPAA or its implementing regulations. Providers should continue to provide telemedicine services using HIPAA-compliant telecommunications methods, enter into business associate agreements with technology vendors, when applicable, and comply with the minimum necessary standard for disclosures of protected health information.

    Similarly, none of the recent NYS legislation enacted relative to the COVID-19 crisis exempts the State privacy laws. Accordingly, you must ensure that medical services delivered by telemedicine are in compliance with HIPAA and the stricter New York privacy laws.

    Some recommendations related to privacy:

    • Use HIPAA compliant technology,
    • Use a secure connection;
    • Use encrypted data;
    • Ensure that virtual visits are not audible to outside parties.

  • In emergency situations like COVID-19, are there exceptions to the HIPAA privacy laws?

    Yes. the HIPAA Privacy Rule always allows patient information to be shared for the following purposes and under the following conditions in emergency situations:

    • Treatment: Under the Privacy Rule, covered entities may disclose, without a patient’s authorization, protected health information about the patient as necessary to treat the patient or to treat a different patient.
    • Public Health Activities: The HIPAA Privacy Rule recognizes the legitimate need for public health authorities and others responsible for ensuring public health and safety to have access to protected health information that is necessary to carry out their public health mission. Therefore, the Privacy Rule permits covered entities to disclose needed protected health information without individual authorization:
      • To a public health authority, such as the CDC or a state or local health department, that is authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury or disability.
      • At the direction of a public health authority, to a foreign government agency that is acting in collaboration with the public health authority.
      • To persons at risk of contracting or spreading a disease or condition if other law, such as state law, authorizes the covered entity to notify such persons as necessary to prevent or control the spread of the disease or otherwise to carry out public health interventions or investigations.

  • Are there changes regarding billing/reimbursement/coding relative to telemedicine used in treating COVID-19

    Yes! The New York State Department of Financial Services will require insurance companies to waive co-pays for telehealth visits. This action will encourage New Yorkers to seek medical attention from their homes rather than visit a hospital or doctor's office - https://www.governor.ny.gov/news/during-coronavirus-briefing-governor-cuomo-announces- department-financial-services-will-require

    In addition, NYS Medicaid expanded coverage of telehealth services in 2019. Per the Insurance Law and Public Health Law, services that are covered under a comprehensive health insurance policy or contract cannot be excluded when the service is delivered via telehealth. To the extent it is practical, the Department is encouraging the use of telehealth to provide COVID-19 related services to Medicaid members. More information on the current telehealth policy can be found:
    https://www.health.ny.gov/health_care/medicaid/program/update/2020/docs/2020‐03‐10_covid‐ 19.pdf

    Medicare reimbursement for telemedicine has recently been changed by HR.6074 - Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020. In Division B of that Act it basically provides for a temporary waiver based upon the originating site and geographic requirements for telehealth services provided to Medicare beneficiaries located in an identified “emergency area” during an “emergency period” when provided by a qualified provider.

    To qualify for the waiver, the provider must have treated the patient within the previous three years or be in the same practice (i.e., as determined by tax identification number) of a practitioner who has treated the patient in the past three years.
    https://www.congress.gov/116/bills/hr6074/BILLS- 116hr6074enr.pdf

    Private insurers are also adapting their reimbursement policies and CPT codes for COVID-19:
    https://www.ama-assn.org/press-center/press-releases/new-cpt-code-announced-report-novel-coronavirus-test

    Moreover, here are some ways health insurance providers are taking action:
    https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/

  • Does telemedicine expose me to additional medical liability risk and how do I mitigate those risks?

    Maybe. The same standard of care applies, but you will be providing that care in new situations and in new ways. Telemedicine potentially exposes a physician to increased risk simply because the patient is not physically present for testing and examination. In addition, physicians will need to address the privacy concerns mentioned above. Some ways to mitigate these risks include, but are not limited to:

    • Create, maintain and update medical records for all telehealth provided similarly to an in-office visit;
    • Adhere to the same follow-up care requirements as in-office visits; and
    • Remember that any issuance of professional advice or treatment, even if gratuitous, is considered part of a physician-patient relationship
    • Keep updated on the literature regarding the use of telemedicine in the COVID-19 environment;
    • Keep updated on the use of telemedicine provided by State and Federal agencies;
    • Keep updated with risk management and legal updates by MLMIC;
    In the age of COVID-19 telemedicine represents a key component in the diagnosis and treatment of the virus. It is vitally important that physicians practicing telemedicine keep apprised of changes that will play a role in their delivery of essential medical services during this time of crisis. Additional information may be obtained through MLMIC at tgray@mlmic.com and Fager Amsler Keller & Schoppmann, LLP at amercado@fakslaw.com and nmayskinner@fakslaw.com

  • Am I immune from liability for treating COVID-19 patients?

    The U.S. Department of Health and Human Services has issued a declaration pursuant to the federal Public Readiness and Emergency Preparedness Act (PREP Act) which provides certain liability protections for individuals and entities related to the use of qualified drugs and other products to treat COVID-19. Specifically, licensed health professionals are immune from liability for prescribing, administering, or dispensing “Covered Countermeasures” – defined as “any antiviral, any other drug, any biologic, any diagnostic, any other device, or any vaccine, used to treat, diagnose, cure, prevent, or mitigate COVID-19, or the transmission of SARS-CoV-2 or a virus mutating therefrom, or any device used in the administration of any such product, and all components and constituent materials of any such product.” While the scope of the HHS declaration is subject to interpretation, it does not appear to broadly grant providers immunity from professional liability for all actions related to COVID-19. The specific application of the declaration will depend on the particular facts and circumstances of each case.

  • If I come out of retirement to assist during the COVID-19 pandemic, will it terminate my free tail coverage with MLMIC? Will I be covered for the work I am returning to do under my free tail coverage?

    If you come out of retirement to assist during the COVID-19 pandemic, it will not terminate your free tail coverage from MLMIC, nor will it alter your ability to report claims from your expired policy. But, you will need new coverage for the work you are returning to do. You can check to see if you have this coverage from your employer or hospital, or if you would like to speak with us about providing this coverage, please call or email us.

  • Can I request a payment accommodation from MLMIC?

    Yes. To request an accommodation that your MLMIC 4th quarter billing installment be deferred until April 30, 2020 due to a COVID-19 related financial hardship, kindly email us at Covid19paymentdelay@mlmic.com to advise us of your request in writing. Please include a list of applicable policy number(s) in your email.

  • What is ‘suspension of practice’?

    When we underwrite you and your practice, ‘suspension of practice’ means that you are no longer providing any professional services for a period up to one year. Under these circumstances, you may request MLMIC to suspend your policy. If approved, an endorsement will be issued to remove coverage from your policy while it is suspended. You should notify MLMIC in advance of the date you wish to return to practice so that your coverage may be reinstated on a timely basis.

  • If I suspend my policy will it reduce my premium?

    Yes, claims made policyholders can receive a discount during the suspension period and can still report claims which relate to professional services provided prior to the suspension period. Occurrence policyholders do not pay premium during the suspension period. For more specifics, and/or any questions, please contact the MLMIC Underwriting Department.

  • Will my hospital and other certificate holders be notified if my coverage is suspended?

    Yes, all hospitals and other certificate holders will be notified if your coverage is suspended.

  • What happens if I provide professional services while the policy is suspended?

    There would be no coverage for a claim resulting from professional services provided (or that should have been provided) during the period of suspension.

  • What if I still need to provide professional services while my policy is suspended?

    If you believe you still need to provide professional services while your policy is suspended (e.g., provide medical advice, fill prescriptions, respond to an emergency, etc.), then your policy should not be suspended. You may wish to consider part-time coverage instead.

  • As a result of the COVID-19 healthcare response, will the New York State Executive Order provide immunity to a licensed physician who is asked to provide medical care or perform medical procedures outside of their normal scope of practice or experience?

    In short, yes. Our best interpretation is that there will be immunity provided under the temporary order. The Governor wants to ensure that there are enough physicians to treat both, patients with COVID-19 and other ill patients within the State of New York. To that end, his words are to grant immunity from harm or death caused by an act or omission by a physician "in the course of providing medical services in support of the State's response to the COVID-19 outbreak."

  • In New York State’s Executive Order granting immunity, there is an exception for gross negligence. Is it gross negligence for a physician to practice outside of their normal scope of practice or experience in response to the State’s efforts to respond to COVID-19?

    No, the law in New York defines gross negligence to be conduct that evinces a reckless disregard for the rights of others or that smacks of intentional wrongdoing. Medical actions taken in good faith to treat patients in a state of emergency and disaster will not be gross negligence.

  • During the state of emergency and disaster in New York, will medical care and treatment that is outside of a physician’s normal practice be covered under their MLMIC Insurance Company policy?

    Yes, a physician's policy with MLMIC Insurance Company will cover their medical care and treatment that is outside of their normal practice so long as it is taken in support of New York State's response to the COVID-19 outbreak.