CommercialCoverageHigh impact
August 2020 In The Know
EmblemHealth·NY·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth prohibits charging members for COVID-19 related PPE costs (masks, gowns, gloves) and sanitizing expenses for Commercial and Medicaid plans. Any collected PPE fees must be returned to members, with potential provider sanctions for violations.
Action Required
Immediately: Billing team must stop charging EmblemHealth Commercial and Medicaid members for COVID-19 related PPE (masks, gowns, gloves) and exam room sanitizing costs. Review all recent charges and refund any PPE fees collected from members. Update billing procedures to exclude these costs from patient responsibility. Failure to comply may result in Medicaid program sanctions up to termination.