State Announces COVID-19 Testing Billing Protections for Uninsured Individuals

BOSTON — The Baker-Polito administration issued a public-health order to prevent uninsured individuals from receiving surprise bills and co-pays because of a COVID-19 test.

The federal Families First Coronavirus Response Act (FFCRA) provides a number of protections for insured individuals, including a requirement that providers must provide COVID-19 testing without imposing any cost-sharing requirements on the individual.

Currently, providers can submit claims for reimbursement related to COVID-19 testing for uninsured individuals to the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured Program, administered by the federal Health Resources and Services Administration. When providers choose to submit reimbursement claims to the portal, the same protections in the FFCRA apply to uninsured individuals.

The Commonwealth has received reports of some providers choosing not to bill the portal, leading to uninsured individuals receiving, at times, large bills for testing.

This week’s public-health order, signed by Department of Public Health Commissioner Dr. Monica Bharel, requires that, when testing uninsured individuals, providers either bill the federal uninsured portal for reimbursement or provide the test at no cost to the individual.

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