New York is ordering health insurers to waive costs for patients tied to coronavirus testing as a second case of the COVID-19 virus was confirmed in a Westchester County man.
The move comes as New York state health officials raced to test more people amid an urgent effort to contain the infectious disease that is spreading in the U.S., reaching 100 cases, including six deaths in Washington State.
In New York, state regulators ordered health insurers to waive cost sharing associated with testing for novel coronavirus, including emergency room, urgent care and office visits.
New Yorkers on Medicaid will also not be required to pay a co-pay for any testing related to COVID-19, Gov. Andrew Cuomo said Tuesday.
"Containing this virus depends on us having the facts about who has it, and these measures will break down any barriers that could prevent New Yorkers from getting tested," he said.
A Westchester County man tested positive for the coronavirus disease despite no known travel links to China or other countries at the center of the outbreak, raising concerns that the virus is spreading in the community.
The 50-year-old man, who lives in New Rochelle and works in Manhattan, remained in a New York City hospital and has an "underlying respiratory illness," Cuomo said.
The case marked New York's second confirmed COVID-19 case, following a health care worker from Manhattan who remained quarantined in her apartment. The 31-year-old woman contracted the virus traveling abroad in Iran.
Both of the cases were confirmed at the state's Wadsworth Lab in Albany, just days after New York received federal approval to test for the virus in-state.
Currently all COVID-19 tests being conducted at the state's Wadsworth Lab are fully covered by health insurance, Cuomo said.
Doctors nationally are bracing for a rapid rise in U.S. coronavirus cases this week as state and local public health labs ramp up testing following weeks of delays due to a flawed test by the U.S. Centers for Disease Control and Prevention.
New York Health Commissioner Dr. Howard Zucker urged New Yorkers who are ill, including with symptoms of coronavirus, to call their health care providers or a medical facility to discuss the situation.
"Use good common sense and judgment on these issue, if someone is ill they should speak with their health care provider," he said.
How do you know when you should be tested for coronavirus?
Common signs of COVID-19 infection include fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and death.
Priority testing is already in place for people with symptoms and a travel history to an area affected by the outbreak that began in China and quickly spread to dozens of other countries, including recent surges in Italy and South Korea.
There are also protocols currently related to ruling out other respiratory illnesses, such as the seasonal flu, before pursuing the coronavirus test.
"You don't have the capacity to treat everybody," Cuomo said Tuesday, adding New York is currently capable of testing several hundred cases per day and aims to reach 1,000 per day soon.
Yet the circumstances linked to the Westchester man are similar to cases in Washington, where authorities are scrambling to track down potential exposures that are straining testing efforts.
A Seattle-area researcher said his genetic analysis shows the virus likely has been circulating undetected in Washington State for six weeks. That means more people in the community, even those who have not traveled to endemic regions, might face risk of exposure.
"You take one of these situations and you're tracking back possible exposures, you see the numbers increasing very quickly," Cuomo said Tuesday, referring to efforts to track potential exposures linked to the Westchester case.
"So getting our testing capacity up is critical. We're working with private laboratories where the Department of Health will share their testing protocol with those laboratories," Cuomo said.
Further, state health officials are finalizing protocols to determine exactly who will be tested for coronavirus as the number of cases are expected to keep rising in New York, Cuomo added.
"You have to have a protocol on the front end of who you will test, or who needs to be tested," Cuomo said.
"And the front end has to be met by the back end of the system, right? So, the number of tests that you're bringing in have to be the number of tests that you can perform.
"We're not at the 1,000 tests per day test level now. We're at the couple of hundred tests per day. So, you prioritize who can be tested."
What are NY's health insurance rules for coronavirus testing?
New York's new rules announced this week prohibit health insurers from imposing cost-sharing on an in-network provider office visit or urgent care center when its purpose is to be tested for COVID-19.
They also prohibit health insurers from imposing cost-sharing on an emergency room visit when its purpose is to be tested for COVID-19.
New York health insurers are also required or advised to take a series of other actions linked to the coronavirus outbreak.
That includes updating consumers about benefits and, where possible, offering telehealth medical advice and treatment, Cuomo said.
New Yorkers enrolled in self-funded employer-based health insurance plans that are not regulated by the state due to the Employee Retirement Income Security Act of 1974 should contact their employer to fully understand the scope of coverage, Cuomo said.
For people without health insurance, there are existing rules in New York related to charity care based on income eligibility and other factors.
For further details about the costs for accessing health care, contact the state Department of Financial Services at (800) 342-3736, or via its website dfs.ny.gov.
Cuomo also said he will amend the state's new Paid Sick Leave law in the state budget for the fiscal year that starts April 1 so employees cannot be fired if they stay home from work because they are being isolated or quarantined as a result of the virus.
Where do you go to get tested for coronavirus?
New York is conducting COVID-19 testing at the state-run Wadsworth Lab in Albany, but authorities are partnering with private-sector laboratories to ramp up the testing.
Currently, people who think they have coronavirus would get treated at local health care facilities that send samples to Wadsworth.
In the Westchester confirmed case, the man was first treated at Lawrence Hospital in Bronxville before being transferred to a Manhattan hospital, Cuomo said.
Hospital officials in Rochester noted if someone with symptoms of a respiratory infection presents at UR Medicine’s Strong Memorial Hospital, they would first be tested for seasonal flu.
That test can be done in-house.
If the flu test was negative, doctors would then consider whether the patient had traveled to a country identified by the Centers for Disease Control and Prevention as having a major COVID-19 outbreak, or had a direct connection to someone who’d been to one of those countries.
If so, the hospital would collect a sample and, through the local public health department, have it transported to the Wadsworth Center for analysis.
Asked what would happen if the patient had not been overseas but had been in a location such as Seattle where there is a local outbreak, Dr. Brenda Tesini, associate hospital epidemiologist at Strong, said they might still send a sample to the lab for testing.
“I would say that this is a rapidly evolving target,” Tesini said.
“We can always discuss cases with public health officials that may not meet the strictest definitions to determine the particular level of risk to determine if testing is still warranted.”
UR Medicine is working with state health officials to develop a test that could be done at the medical center, Tesini said.