Thousands of New Yorkers are getting refunds after being wrongly charged for medical services that should have been free.
Attorney General Letitia James announced a settlement with Fidelis Care after an investigation found the insurer improperly billed patients for COVID-19 testing visits and certain HIV screening services.
State law required those services to be covered at no cost to patients, but some consumers received bills totaling hundreds of dollars. The attorney general said the charges placed unnecessary financial stress on families during a public health crisis.
The investigation found that between October 2021 and August 2022, patients were billed for more than 38,000 office visits tied to COVID-19 testing, affecting over 18,000 people. Between January 2022 and May 2023, more than 2,800 HIV screening services were improperly billed, impacting more than 2,100 consumers.
As part of the agreement, Fidelis reprocessed tens of thousands of claims and paid more than $2.6 million to providers for COVID-19 testing visits and more than $157,000 for HIV screening services, including interest. The insurer also ensured providers canceled improper bills and refunded consumers who had already paid.
Fidelis sent corrected explanations of benefits to affected members and updated its internal systems to prevent similar errors. The company also agreed to stop charging patients for these HIV screening services and to halt collection efforts tied to COVID-19 testing during the public health emergency.
In addition, Fidelis will pay a $175,000 penalty to the state. Under the settlement, the insurer could face fines of up to $500 for each future violation.
Attorney General James said her office will continue to step in when insurers fail to follow the law. Consumers who believe they were improperly billed can contact the attorney general’s Health Care Bureau for assistance.
FingerLakes1.com is the region’s leading all-digital news publication. The company was founded in 1998 and has been keeping residents informed for more than two decades. Have a lead? Send it to [email protected].