Dive Brief:
- California Attorney General Xavier Becerra issued an alert Tuesday for patients facing "COVID fees" from providers, for extra cleaning and personal protective equipment expenses incurred while receiving care.
- Those enrolled in the state's Medicaid program through Medi-Cal and Denti-Cal are not allowed to be charged such fees and should refute them with their providers or call a helpline, as should Medicare patients, according to a statement from Becerra, who is President Joe Biden's nominee to run HHS.
- California patients with private insurance may ask providers about a COVID-19 fee and what the charge covers and should contact their insurer to discern whether the fee is allowed under their plan's rules. They should also file a complaint with the state's department of managed care, according to the release.
Dive Insight:
Some states have issued alerts about price gouging in relation to COVID-19, though California's notice targets providers charging patients for increased expenses they're incurring while providing medical services.
The American Medical Association, along with other state medical associations and national medical specialty societies, have urged payers to compensate providers for extra supplies and new staff roles required to provide safe patient care.
An AMA survey of 3,500 physicians taken in July and August found practice owners reported a 57% rise on average in PPE expenses since February 2020.
Almost all respondents said they implemented protocols like pre-visit screening calls to check for symptoms, on-site temperature checks and other mechanisms to protect patients from COVID-19. And 81% of respondents said revenue was lower than prior to the pandemic, with an average revenue drop of 32%.
A variety of providers are charging these fees, but so far it appears to primarily be doctors and dentists' offices, according to an email statement from a spokesperson at Becerra's office.
Providers in the Medicaid and Medicare programs are required to accept the program's fee-schedule amount as payment in full, barring them from charging patients for the cost of PPE when delivering services under those programs, according to a spokesperson.
"Depending on the facts of the particular charge, there could be other violations of law, but we can't provide legal analysis," the spokesperson said.
Patients already charged with a COVID-19 fee from a recent visit with a provider should contact their insurer and request a reimbursement, the office said.
Medi-Cal, Denti-Cal, Tricare and Medicare dual eligible patients should file a complaint and report which provider charged the fee, along with their dental or health insurance company.
Patients with Tricare coverage can't be charged COVID-19 fees at in-network providers, unless they don't inform the provider ahead of time they have the coverage and the provider sends a written notice about a fee prior to an appointment, according to the release.
Becerra, who is set for Senate votes on his confirmation as HHS secretary after barely getting through the Senate Finance Committee on Wednesday, received sometimes harsh questioning about his legal actions in healthcare, including multiple lawsuits against the Trump administration.