Fidelis Care Accused of Charging for Free Services in NY

New York Attorney General Letitia James has cracked down on Fidelis Care, a health insurer based in the state, after an investigation revealed that the company wrongfully charged New Yorkers for services that should have been free. Between October 2021 and August 2022, over 18,000 consumers were affected by charges for COVID-19 testing, with another 2,100 impacted by HIV screening fees, despite these services being legally covered at no cost to patients.

The Office of the Attorney General (OAG) investigation found Fidelis reprocessed tens of thousands of claims and paid more than $2.8 million to affected providers. Consumers who were charged out-of-pocket have been refunded, and the insurer has committed to fixing its internal systems to prevent future errors. Additionally, a penalty of $175,000 will be paid by Fidelis to the state.

Attorney General James emphasized the importance of legal protections for New Yorkers during public health crises, stating, ‘No New Yorker should ever face a surprise medical bill for care the law says must be free.’

The investigation revealed that Fidelis required patients to pay out-of-pocket costs for services like COVID-19 testing and HIV screenings, which were supposed to be provided without charge during the federal Public Health Emergency. The company has now agreed not to charge patients for these services again and will notify consumers of any additional errors.

Patients who believe they may have been victims of misleading billing practices by Fidelis Care are encouraged to contact OAG’s Health Care Bureau online or by calling 1-800-428-9071. The matter was handled by Assistant Attorney Generals Eve Woodin and Brant Campbell, under the supervision of Deputy Bureau Chief Leslieann Cachola and Bureau Chief Darsana Srinivasan.