What you need to know about the forces reshaping our industry.


November 11, 2020

A $900 'Covid-19 fee'? More patients face steep billing surprises.

Daily Briefing

    To recoup some of the financial losses that have come in the wake of the Covid-19 epidemic, dentists, assisted living facilities, and other providers have been charging Covid-19-related fees—which are often not covered by insurance, Sarah Kliff and Jessica Silver-Greenberg report for the New York Times' "The Upshot."

    How Covid-19 will impact the financial outlook for the health care industry

    Surprise Covid-19 fees

    The epidemic has hit the health care industry hard, but dentists and assisted living facilities have been especially affected, Kliff and Silver-Greenberg report, as people have postponed nonurgent dental care and assisted living facilities have had to scale back occupancy.

    To counter this, some providers have billed consumers for "Covid" and "PPE" fees, according to bills examined by the Times, and these fees are often a surprise to consumers.

    For example, Carrie McGurk, a retired lawyer in Florida, noticed a $15 charge on her dental cleaning bill from July—a charge she wasn't informed of in advance.

    "When I was putting [the bill] away in my file, I saw 'Covid charge' and thought, Jeez, you could have at least told me," she said.

    The American Dental Association (ADA), which "strongly encourages" dentists to disclose additional fees to their patients, has asked dental health plans to start covering a new fee to cover the cost of dentists purchasing heavy personal protective equipment (PPE), Kliff and Silver-Greenberg report. But while some health plans have, other haven't, meaning patients are left paying the full fee, Kliff and Silver-Greenberg report.

    According to Kliff and Silver-Greenberg, regulators in Connecticut, Maryland, and New York have received a number of complaints from consumers about new fees at dentist offices.

    "We're seeing complaints of all types," William Tong, Connecticut's attorney general, said. "All the arguments in favor of billing patients are not at all compelling to me."

    According to Mark Parkinson, CEO of the American Health Care Association and National Center for Assisted Living, occupancy levels at assisted living facilities are at record lows. "Revenue is at record lows, and expenses are at record highs," he said, adding that the industry only received federal assistance in September.

    "There is a real desire to not have to pass on any of these costs," Parkinson said.

    But Michael Hambley, who runs a continuous care facility, feels there may be another motive. He learned that the assisted living facility his mother is in charged her a one-time, $900 fee for masks, cleaning supplies, and meal delivery.

    "It seemed like this was an opportunity to take advantage of a population that is already vulnerable," he said. "They have no visits, no engagement. And on top of that they are scared."

    After Hambley submitted a complaint about the fee to state regulators, the facility rescinded it.

    Why Covid-19 fees may become more common

    These types of fees may become more common among other health care providers soon, Kliff and Silver-Greenberg report.

    Last month, the American Medical Association (AMA) lobbied Medicare to start reimbursing for a new billing code covering increased costs associated with PPE. AMA proposed Medicare reimburse $6.57 for protective equipment costs and new procedures per visit.

    A spokesperson for Medicare declined to comment on whether the fee will be approved, but did say Medicare had already "provided additional funding to support providers responding to the Covid-19 [epidemic]" (Kliff/Silver-Greenberg, "The Upshot," New York Times, 11/5).

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