CityMD and some other privately held health care providers in New York City are beginning to bill uninsured patients for COVID-19 testing and treatment after a key federal funding stream dried up March 22.
Similar funds to cover the cost of administering COVID-19 vaccines to uninsured patients expired on Tuesday. Although providers can’t bill patients for the shots, they can stop offering them, according to an analysis by KFF.
The U.S. Health Resources and Services Administration (HRSA) announced in mid-March that it would not be accepting reimbursement requests for these COVID-19-related services “due to insufficient funds.” The money dried up when lawmakers in Congress hit an impasse last month over how much more COVID-19 aid should be approved.
While negotiations are ongoing, city-run health centers will continue to provide COVID-19 services to everyone, regardless of insurance status, a New York City Department of Health spokesman confirmed Tuesday.
But Kamin Health, a small emergency care company with locations in Brooklyn and Queens, began charging people without insurance $75 for a rapid test and $125 for a PCR test on March 31.
“We are literally forced to pay our bills,” said Yosef Hershkop, a regional manager for the company.
Hershkop estimated that Kamin made “tens of thousands” of dollars in just the week and a half between the time HRSA didn’t accept reimbursement claims for COVID-19 visits and the time Kamin started requiring patients to either pay out of pocket or to supply, has lost their insurance data.
On Tuesday, Hershkop said Kamin would continue to provide free COVID-19 vaccines to all patients for the time being, but that he “cannot predict the future.”
Emergency care giant CityMD posted on its website Monday that it will also bill patients without insurance for visits related to COVID-19. It says those who have health insurance may also have to pay co-payments or other expenses, depending on their health plan. CityMD does not offer COVID-19 vaccines.
New Yorkers receiving COVID-19 care should inquire in advance about out-of-pocket fees.
GoHealth, Northwell Health’s emergency care arm, charges uninsured patients between $120 and $195 in addition to lab fees for a PCR test, according to ABC.
Adina Genn, a spokeswoman for GoHealth, said patients with insurance will not be billed for anything out of pocket “where required by applicable regulations”.
During the ongoing public health emergency declared by the federal government, healthcare plans are generally required to cover diagnostic COVID-19 testing at no patient cost-sharing. But that could change if the state of emergency is allowed to expire on April 16.
CVS said Tuesday it’s still offering free testing and vaccines to those who don’t have insurance, while keeping hopes alive for new federal funding.
“We are convinced of it [Biden] The administration and Congress will find a solution to ensure people without insurance continue to have access to COVID-19 testing, vaccines and treatment,” Amy Thibault, a CVS spokeswoman, said in a statement. “As demonstrated throughout the pandemic, we are committed to working closely with federal and state officials to provide access to testing, treatment and vaccines to support the communities we serve.”
On Monday, U.S. Senate lawmakers reached an agreement to set aside $10 billion to further cover COVID-19 supplies and services, Politico reported. The White House has urged Congress to quickly process the spending bill, even though it falls far short of the $22.5 billion requested by President Joe Biden’s administration.
Consequences for the insured
Although the expired HRSA funding was dedicated to covering COVID-19 care for people without insurance, healthcare providers say other patients could also be affected by the postponement.
Some of the privately operated mobile vans and other COVID-19 testing sites that have popped up during the pandemic have not bothered to push patients’ insurance information very strongly. Health care sources say it’s probably because they knew they could be reimbursed for HRSA regardless.
“It’s going to be those providers that go away” if state funding isn’t restored, predicted Steve Moore, former president of the New York State Pharmacists Society.
Moore added that some pharmacies and other healthcare practices across the state have billed the HRSA for COVID-19 testing even if a patient is insured because an insurance company is more likely to question whether a test is medically necessary.
Kamin Health’s Hershkop said health insurers have recently begun to challenge more claims for COVID-19-related care — for example, by asking why a patient needs a test or why they were tested so frequently.
It’s possible that some healthcare providers may simply request more insurance information and conduct health questionnaires to justify testing or treatment.