Today, Congresswoman Lizzie Fletcher (TX-07) and Senator Tina Smith (D-MN) introduced the Stop COVID-19 Test Surprise Medical Bills Act of 2020, legislation to end surprise medical billing for COVID-19 tests and ensure anyone can get one without having to pay a cost-share.  Although both the Families First Act and the CARES Act included measures to ensure that COVID-19 diagnostic tests are accessible and affordable, there have been reports since the beginning of the pandemic of patients being denied insurance coverage or being charged massive surprise bills or co-pays by providers for their test.  This legislation will clarify with insurance providers that individuals can get tested for any reason, prohibit providers from collecting co-pays for tests, and provide transparency in testing pricing.

“We know that testing is key to containing the spread of COVID-19 in our communities, and Congress has passed several measures to make testing as affordable and accessible as possible.  Through the pandemic, however, constituents have contacted my office for help with surprise medical bills they received from getting a COVID-19 test,” said Congresswoman Lizzie Fletcher.  “This is unacceptable.  The Stop COVID-19 Surprise Medical Bills Act will ensure anyone who needs a COVID-19 test could get one without worrying about how much they need to pay and add much-needed transparency in pricing.” 

“If we listen to our nation’s health experts, we know that testing continues to be essential to getting a handle on this pandemic,” said Senator Tina Smith. “It’s imperative that COVID-19 tests are not only readily available to anyone who suspects they have been exposed to the virus, but also that individuals do not get hit with a surprise medical bill for their test. Our legislation will help protect Americans from facing this unanticipated expense.” 

In order to end surprise medical billing for COVID-19 tests and increase test price transparency, this legislation would specifically:

• Clarify that an insurance provider can’t impose cost-sharing or prior authorization surrounding the reason why someone sought testing (i.e. asymptomatic individuals, those with no known exposure, back to school and back to work testing, or public health surveillance). 
• Require the HHS Secretary to survey a sample of providers representing a diversity of sizes, geographic locations, and care settings to collect information surrounding the price they are charging for COVID-19 tests.  While insurance providers were required under the CARES Act to list the cash price for a COVID-19 test on their website, many have failed to do so.  This has allowed for huge discrepancies in price across the country and price gouging.  Through this legislation, HHS will publish a report that includes the average price for their tests, a comparison of such average cash price to the reimbursement rate under the Medicare program, and any outlier cash prices (including the names of the providers charging such prices).
• Require the Secretaries of HHS, Labor, and Treasury to publish guidance to clarify 1) the process by which providers should submit claims for COVID-19 tests to individual or group plans and 2) that providers should not collect cost-sharing amounts from individuals seeking a test.