The Perfect Enemy | CityMD promises to refund NYC patients for surprise COVID-19 testing bills - Gothamist
January 29, 2023

CityMD promises to refund NYC patients for surprise COVID-19 testing bills – Gothamist

CityMD promises to refund NYC patients for surprise COVID-19 testing bills  Gothamist

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After blindsiding patients with bills for COVID-19 tests that most assumed would be free, the urgent care chain CityMD said it is now waiving balances and issuing refunds.

CityMD began sending the bills out last summer, in some cases for tests that were administered at the height of the pandemic in 2020. As Gothamist first reported, the company said at the time that the bills were arriving late because it had tried to work with patients’ insurers to get reimbursed for the charges first. But in a post on its website last month, CityMD reversed course and said it would stop billing patients — for now.

“After continued coordination with insurance carriers and review of related guidance, CityMD is recalling COVID-19 testing-related bills and removing any related balance from patient accounts,” the notice said.

But CityMD added that once the federal public health emergency around COVID-19 ends, it could resume charging patients for COVID-19 tests. The secretary of the U.S. Department of Health and Human Services has renewed the public health emergency continuously since it was put in place in early 2020. The most recent renewal came last week, and each one extends the emergency period by 90 days. The HHS has pledged to give states 60 days notice if it ever plans to not renew the order.

CityMD said in the notice that it had contacted patients to inform them that they were no longer responsible for the charges. But Manhattanite Helene Purcell said she didn’t find out her balance had been waived until she received a letter from the New York attorney general’s office this week.

Purcell had filed a complaint with the attorney general’s office in October, after receiving a $208 bill from CityMD for a COVID test she got in December 2020. In the complaint, she referenced Gothamist’s story on the issue, showing she was not alone.

“I was furious at the fact that we were told one thing and then, behind closed doors, they were like, ‘Oh no, actually you weren’t listening. This is not free to you,’” Purcell said.

One of the first actions the federal government took in response to COVID-19 in spring 2020 was to make testing free to patients — but that came with some caveats. Federal law requires insurers to cover the full cost of a test as long as the public health emergency around the pandemic is in place.

But it has been less clear what recourse health care providers have if an insurance company fails to do that. In CityMD’s case, it seems some health insurers declined to pay the urgent care chain’s charges for an “office visit” in addition to the test itself.

Some patients have balked at the charges from CityMD, calling them a “scam.” But health policy experts who have spoken to Gothamist about this issue have said that federal law largely placed the onus on insurers to prevent patients from getting charged.

Gothamist began reaching out to the HHS in September 2022 to gain some clarity on the issue and find out what guidance the agency had distributed to health care providers and insurers. A spokesperson, Jorge Silva, initially said he was running down a response – but then went silent. After posing the question again this week, Gothamist found that Silva had left the agency and started over with a new spokesperson, Ilse Zuniga, who has yet to respond.

Multiple people affected by the CityMD charges told Gothamist last year that they were involved in an investigation into the urgent care chain by the New York attorney general’s office. But the attorney general’s office has not confirmed that it is looking into the issue.