Today, Congresswoman Lizzie Fletcher (TX-07) announced she will re-introduce her legislation to end surprise medical billing for COVID-19 tests tomorrow.  While Congress has passed legislation both to end surprise medical billing and to ensure COVID-19 tests are accessible and free, loopholes allow insurers to arbitrarily charge cost-shares.  Fletcher’s Stop Surprise Medical Billing for COVID-19 Tests Act closes these loopholes by clarifying with insurance providers that individuals can get tested for any reason, directs federal health officials to issue guidance on how to submit claims to protect patients from surprise bills, and provides transparency in testing pricing.

“Even as vaccines offer new hope in the fight against the coronavirus, COVID-19 testing continues to be key to slowing the spread of the virus in our communities,” said Congresswoman Lizzie Fletcher.  “Through the pandemic constituents have contacted my office for help with surprise medical bills they received from getting a COVID-19 test.  This is unacceptable.  My bill will ensure anyone who needs a COVID-19 test can get one without worrying about how much they need to pay and will add much-needed transparency in pricing.”

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 cannot 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.

The Stop COVID-19 Surprise Medical Bills Act is co-sponsored by Representatives Cindy Axne (IA-03), Veronica Escobar (TX-16), Sylvia Garcia (TX-29), Raúl M. Grijalva (AZ-03), Alcee Hastings (FL-20), Jahana Hayes (CT-05), Eleanor Holmes Norton (DC-AL), Sheila Jackson Lee (TX-18), Hank Johnson (GA-04), Mondaire Jones (NY-17), Al Lawson (FL-05), Mike Levin (CA-49), Katie Porter (CA-45), Kim Schrier, M.D. (WA-08), Mark Takano (CA-41), Nydia M. Velázquez (NY-07).

Fletcher, a member of the Energy and Commerce Health Subcommittee, first introduced this legislation last September, and it passed as a part of the updated Heroes Act.