CityMD Wrongfully Charges Patients for COVID-19 Tests, Class Action Alleges

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A proposed class action claims Summit Health Management earlier this year began improperly charging patients for “free” COVID-19 tests administered at CityMD urgent care offices.

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The 21-page case alleges Summit Health, the owner and operator of over 150 CityMD urgent care medical centers in the New York metropolitan area, has since May 2022 billed patients $300 for each COVID-19 test they received at a CityMD location by disguising the service to insurance companies as an “office visit.” The filing contends that Summit Health’s “deceptive scheme” has circumvented the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, Economic Security (CARES) Act, which stipulate that COVID-19 tests administered by healthcare providers are free of charge. 

Related Reading: Reyes v. Summit Health Management, LLC

According to the complaint, Summit Health has taken advantage of hundreds of thousands of individuals who lined up at CityMD locations, particularly throughout 2020 and 2021, under the “widespread knowledge and belief that, by virtue of these laws, they would receive free COVID tests.” 

Before an individual received a COVID-19 test at a CityMD facility, most of which were administered over a year ago, the clinic did not require insured patients to pay anything, the filing says. After CityMD sent patients’ rapid or PCR test results electronically, “such persons received no further communications regarding their Summit Health CityMD Covid Test until about May 2022 when Summit Health started its campaign to bill them for Covid Tests that they previously believed to be free,” the case states.

Per the filing, Summit Health submitted claims to insurers that coded visits for COVID-19 testing as general office visits.

“Ignorant that their insureds actually had COVID tests, for which the insureds were not required to pay anything, the insured health insurance companies processed the claims as ordinary medical non-Covid related claims,” the case summarizes. “[W]hen the insureds had co-pays and/or deductibles, [health insurance companies] did not pay the full amount to Summit Health or CityMD, both of which, then, billed the consumers for all of the amounts not paid by the insurers.”

The plaintiff, a New York patient, claims to have received several bills from Summit Health and CityMD in August 2022 that charged her $550.13 for “office visits” in place of the five COVID tests she took throughout 2020 and 2021 at a CityMD facility. Although two of the $300 “office visits” appeared as “paid by insurance,” three tests were only partially covered, and the plaintiff has paid $140 toward one of these bills, the suit asserts.

As the case tells it, if Summit Health coded and billed for the actual services the plaintiff and other affected individuals received, they would not be financially responsible for any costs associated with COVID-19 testing, as stipulated under the FFCRA and CARES Act.

The lawsuit relays that the Better Business Bureau has received over 130 complaints from consumers who say they have been improperly billed for a COVID-19 test at a CityMD clinic. Further, Summit Health “has harassed these consumers by sending repeated bills by mail, email, and text and by threatening to refer their bills to a collection agency,” the suit contends.

“These efforts have led to Plaintiff and members of the Class improperly paying Summit Health out of their own pockets for their COVID tests,” the lawsuit shares. 

The lawsuit seeks to recover for the plaintiff and other affected individuals the portion of Summit Health’s alleged $300 “office visit” charge that insurers do not cover.

The case looks to represent anyone who obtained a COVID-19 Test at a CityMD facility since April 1, 2020 and has been billed for any part of CityMD’s charge for an “office visit” in connection with their COVID-19 test.

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