Provided by:  Jennifer Kirschenbaum, Esq.

October 22nd, 2020



Hi Jennifer,

Can I seek reimbursement from an insured patient’s insurance company or from the patient for the cost of PPE or Covid-19 related precautions (barriers, screens, etc.)?  

Dr. P


Nope.  Not to the extent you are a participating provider.  Effective August 5, 2020, the State of New York  implemented a mandate that providers participating with insurance companies should not charge insured patients any fees for PPE that exceed that  patient’s normal financial responsibility.   NYS Department of Financial Services (DFS) issued this mandate after receiving numerous complaints from those being charged for PPE.  In relying on Insurance Law §§ 3217-a(a)(5) and 4324(a)(5) and Public Health Law § 4408(1)(e), DFS stated that the law “clearly require issuers to disclose the insured’s financial responsibility for covered services, including any other charges, and such disclosure should be made for medical and dental coverage.”  In addition DFS states, “A provider who participates with an issuer’s provider network has agreed to accept a reimbursement amount from the issuer for covered services, with the insured responsible for the cost-sharing set forth in the insured’s health or dental insurance policy or contract.  A participating provider should not charge the insured fees or other charges in addition to the insured’s financial responsibility for covered services.