Better Solutions for Healthcare

NYT: A New Item on Your Medical Bill: The ‘Covid’ Fee

By Sarah Kliff and Jessica Silver-Greenberg

November 5, 2020

When Michael Hambley got the call from his 87-year-old mother in July, he was sure there was a mistake. She told him that her assisted living facility, the one she paid for with her pension, was charging a one-time, $900 fee for masks, cleaning supplies and meal delivery.

Jennifer Koeckhoven had a similar experience in June: a $60 personal protective equipment charge — tacked onto her mother’s ambulance bill — that went uncovered by insurance.

“She was already wearing a mask,” said Ms. Koeckhoven, who noted that the one-mile ambulance ride already cost $1,759 before the fee.

In New York City, Zariely Garcia was surprised to see a $45 fee tacked onto a dental cleaning in July. It was billed to her directly, not her health plan, a practice that state regulators outlawed the next month as a violation of consumer protection laws.

The coronavirus pandemic has made the practice of health care more costly as providers must wear protective gear and sanitize equipment more often, even as they face declining revenue. Two groups of providers have been particularly hard hit. Dentists have lost billions since patients began postponing nonurgent dental care this spring. And assisted living facilities, grappling with lower overall demand, have also been forced to admit fewer residents to help stop the spread of infection.

To address this financial shortfall, some health providers are turning directly to patients. Surprise “Covid” and “PPE” fees have turned up across the country, in bills examined by The New York Times.

“It’s a complicated answer, who pays for this,” says Scott Manaker, a physician who is in charge of the American Medical Association’s practice expense committee. “You look around the community and see additional costs being imposed right and left because of Covid-19. Barber shops, pedicures and restaurants all have additional charges. It would be an undue burden to ask the medical community to bear this alone.”

Some of these fees — when millions of Americans are reeling after losing jobs and the health insurance that came with it — have drawn the attention of state attorneys general who say that charging patients directly can take advantage of vulnerable consumers or violate health insurance contracts and consumer protection laws. The new charges range from a couple of dollars to nearly $1,000.

“The cynical view is that some see this as an opportunity: Everyone understands something unusual is going on, and most customers are ready to embrace the idea they will need to bear some expense,” said Darrin Fowler, an assistant attorney general in Michigan who has been investigating coronavirus fees in assisted living facilities. “Unfortunately, in every setting there are a percentage of folks who will take advantage of that situation.”