Senator Pressing New Bill to Stop Surprise Medical Bills For Testing That Could Run to Thousands of Dollars

WASHINGTON, D.C. [7/21/21]—Today, U.S. Senator Tina Smith (D-Minn.) said people in Minnesota and across the country are still being charged up to thousands of dollars for COVID-19 tests that - by law - should be free, and she introduced legislation to help ensure Americans aren’t stuck with surprise bills when they get a test. Senator Amy Klobuchar (D-Minn.) is a cosponsor of the bill.

As part of a COVID-19 relief package in 2020, Congress enacted Sen. Smith’s measure to require public health programs and private insurers to cover the cost of coronavirus tests. The law also protects the uninsured from being charged. Despite the prohibition against testing charges, Americans are continuing to get surprise testing bills that can exceed thousands of dollars, she said.

On Wednesday, Sen. Smith introduced her Stop COVID-19 Test Surprise Medical Bills Act to clarify that all testing should be covered, and providers should be stopped from billing or holding patients liable for the cost of a test regardless of their insurance status. 

“No American who needs a test should be stuck with a surprise bill when they get one. Testing is a key tool in our fight to end this pandemic. These surprise bills are not only costly, but they may discourage people from getting tested in the first place,” said Sen. Smith. “My bill clarifies that COVID-19 tests are free for everyone, and holds accountable those who are flouting the law by charging patients or price-gouging COVID-19 tests.”

Sen. Smith said an 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. 

Senator Smith’s bill would address this problem by:

  • Clarifying 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.
  • Setting a cap on cash prices for COVID-19 tests at 2 times the reimbursement rate under the Medicare program.
  • Prohibiting providers from billing or holding liable individuals—regardless of insurance status—for COVID-19 tests. 
  • Increasing penalties for providers who fail to comply with COVID-19 testing transparency requirements. 
  • Requiring a public report, highlighting which providers are charging prices that substantially exceed the average cash price for a COVID-19 test.
  • Directing 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. 
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