TOPEKA – Kansas Insurance Commissioner Vicki Schmidt is reminding consumers of their rights related to COVID-19 testing. The U.S. Department of Health and Human Services extended their public health emergency declaration, which includes regulations related to COVID-19 testing.
“Earlier this month I issued a consumer alert related to improper billing for COVID-19 testing,” said Schmidt. “With HHS extending their public health emergency declaration it is important to continue awareness efforts of this issue. We have received multiple cases of unallowable charges for COVID-19 testing. If you have been tested for COVID-19 and have questions about charges, please contact this department for assistance.”
Federal law requires COVID-19 testing without cost sharing (including deductibles, copayments and coinsurance) requirements or prior authorization or other medical management requirements, meaning most consumers should not be billed a separate provider or facility fee for receiving a COVID-19 diagnostic test.
Consumers are encouraged to closely review explanation of benefit statements from their insurer to make certain they do not have a cost sharing responsibility for a diagnostic COVID-19 test. Consumers should also communicate with their health care provider the importance of the providers’ submitting claims properly. The Kansas Insurance Department has a Consumer Assistance Hotline, 785-296-7829 or 800-432-2484 to assist consumers who believe they were subject to an improper charge.
Here are two examples of charges that are not allowed:
• Due to exhibiting symptoms, consumer was advised to get a COVID-19 test and went through a drive thru testing center. The consumer was not billed for the test but did receive a bill for a provider fee. This was not a permissible charge.
• Consumer was not feeling well and visited their doctor. The doctor ordered a COVID-19 test, which came back positive. Because the visit to the doctor was connected to the diagnostic test for COVID-19 the consumer should not have been billed for that visit.