Fidelis Care will pay back millions after charging for COVID tests, HIV screenings supposed to be free, attorney general's office says

Fidelis Care, a New York City-based health insurance company, has been required to pay back millions of dollars to health care providers and patients after an investigation found it charged patients for medical screenings that should have been free, the state Attorney General’s Office announced Thursday.

Fidelis reached a settlement with the state after an investigation by the office of Attorney General Letitia James found the company "wrongly required" patients throughout the state to pay bills of "hundreds of dollars" for COVID-19 tests and certain HIV screenings that were supposed to be free under state and federal law, James' office said.

Officials with Fidelis did not offer comment for the story following requests.

"No New Yorker should ever face a surprise medical bill for care the law says must be free," James said in a statement. "Fidelis’ practices placed unnecessary financial stress on families who were simply trying to stay healthy during a public health crisis."

According to the settlement, Fidelis is required to reprocess "tens of thousands of claims" to ensure that health care providers cancel charges to patients who were wrongfully billed, to pay over $2.8 million to impacted health care providers and to refund consumers who already paid for the services, the attorney general's office said.

Additionally, the insurer must pay the state $175,000 in penalties.

Between October 2021 and August 2022, Fidelis required health care providers to charge patients for more than 38,000 office visits related to COVID-19 tests — impacting some 18,000 New Yorkers — that were supposed to be free during the federal public health emergency, the attorney general's office said.

More than 2,100 patients seeking HIV screening services between January 2022 and May 2023 also were wrongfully charged for services that should have been free, according to the attorney general’s office.

Fidelis was required to pay providers $2.6 million for COVID-19 test visits and over $157,000 for HIV screening visits, plus interest, the state said.

Under the settlement, the insurer must notify health care providers and customers if any other wrongly processed claims are discovered, and the company faces fines of up to $500 for any future violations.

Long Islanders who feel they may have been wrongly charged for medical tests that should have been free are encouraged to contact the attorney general’s Health Care Bureau online or call 800-428-9071.