WASHINGTON, D.C. [09/30/20]—Senator Tina Smith (D-Minn.) said far too many people are being forced by their insurance companies to pay for coronavirus (COVID-19) tests that should be free. On Wednesday, Sen. Smith introduced her Stop COVID-19 Test Surprise Medical Bills Act of 2020 to protect Americans from unanticipated COVID-19 test charges. The measure clarifies that insurers cannot refuse to cover medically necessary tests, directs federal health officials to help ensure providers and insurers understand how to submit claims to protect patients from surprise bills, and strengthens price transparency requirements. A House companion was introduced by U.S. Representative Lizzie Fletcher (TX-07).
Right now, Senator Smith’s Free COVID-19 Testing Act—enacted into law as part of the Families First Coronavirus Response Act on March 18—requires public health insurance programs and private health insurance plans to cover the cost of COVID-19 tests and related office visits without imposing cost sharing. The bill also protects the uninsured from these charges.
But unfortunately Americans are still getting stuck with medical bills for their COVID-19 tests. A recent analysis by the New York Times found that individuals are being charged up to $2,718 for “out-of-network” tests and related office visits, and 2.4 percent of COVID-19 tests result in some charges being passed on to patients. And earlier this year a Politico analysis revealed that insurers were receiving charges for COVID-19 tests of up to $2,315 in Oklahoma and as high as $6,496 in Texas. Though these charges don’t always result in bills for patients, Americans may end up paying for these higher costs in the form of higher insurance premiums in future years.
“If we listen to our nation’s health experts, we know that testing continues to be essential to getting a handle on this pandemic,” said Sen. Smith. “It’s imperative that COVID-19 tests are not only readily available to anyone who suspects they may have been exposed to the virus, but also that individuals do not get hit with a surprise medical bill for their test. Our legislation will help protect Americans from facing this unanticipated expense.”
“We know that testing is key to containing the spread of the COVID-19 in our communities, and Congress has passed several measures to make testing as affordable and accessible as possible. Through the pandemic, however, constituents have contacted my office for help with surprise medical bills they received from getting a COVID-19 test,” said Congresswoman Fletcher. “This is unacceptable. The Stop COVID-19 Surprise Medical Bills Act will ensure anyone who needs a COVID-19 test could get one without worrying about how much they need to pay and add much-needed transparency in pricing.”
The Stop COVID-19 Test Surprise Medical Bills Act of 2020 would:
- Clarify that insurers cannot refuse to cover the full cost of or delay access to a COVID-19 test on the basis of whether the test was ordered by a physician, whether the individual seeking a test had symptoms, or whether an individual seeks a test multiple times.
- Direct the Departments of Health, Labor, and Treasury to issue guidance to clarify the process for submitting claims for COVID-19 tests and related office visits so that individuals do not receive charges, and to clarify that providers should not collect charges from patients.
- Strengthen price transparency requirements intended to prevent price gouging for COVID-19 tests by requiring the Department of Health and Human Services (HHS) to survey providers of COVID-19 tests and issue a public report, highlighting which providers are charging prices that substantially exceed the average cash price.
The Stop COVID-19 Test Surprise Medical Bills Act of 2020 is cosponsored by Sens. Patty Murray (D-Wash.), Jeanne Shaheen (D-N.H.), Mazie Hirono (D-Hawaii), Maggie Hassan (D-N.H.) and Amy Klobuchar (D-Minn.)
You can read a summary of the bill here.