Northwell must pay $1M for COVID-19 testing charges during height of pandemic

Northwell Health must pay a $650,000 penalty and refund $400,000 to more than 2,000 patients who were wrongfully charged in connection with COVID-19 tests during the first year of the pandemic, when most coronavirus testing charges were illegal, the New York Attorney General’s Office announced Friday.

Northwell posted signs advertising drive-through COVID-19 testing at Huntington Hospital, and COVID-19 testing at emergency departments at Lenox Hill Hospital and Lenox Health Greenwich Village in Manhattan. But after receiving only COVID-19 tests and related services, 559 patients paid bills for standard emergency room visits, the attorney general’s office said.

Other patients who arrived at the emergency departments “for other reasons were also charged for COVID-19 tests that were administered,” the office said.

Federal and state laws at the time prohibited charges for COVID-19 tests and cost-sharing for those with insurance. The federal government covered testing for some — but not all — uninsured people.

Northwell, which as part of the agreement did not admit to wrongdoing, billed thousands of people for COVID-19 tests or related services, and some of them paid, either while at the emergency department or after receiving an insurance company statement that included a balance due, the 28-page settlement states.

“During a time of great stress at the height of the pandemic, Northwell Health caused more worry and frustration for New Yorkers who were sent emergency room bills for simply taking a COVID-19 test,” Attorney General Letitia James said in a statement. “Today we are putting money back in New Yorkers’ pockets after Northwell Health misled them.”

Emergency department facility charges were about $2,000, the state said. Fees charged for a clinician to evaluate a patient averaged “hundreds of dollars.”

Barbara Osborn, a spokeswoman for Northwell, which is based in New Hyde Park and is the state's largest health care provider, said in a statement that there were “extremely limited instances when patients who sought COVID-19 testing at these three locations did make out-of-pocket payments.”

That led to $81,761 in refunds to 559 patients, the attorney general's office said.

Osborn said that, “out of an abundance of caution, Northwell also voluntarily issued refunds to many patients who received additional services unrelated to COVID-19 testing and evaluation, from whom Northwell was entitled to collect payment, totaling $318,402.83.”

The health system had billing controls that “in the overwhelming majority of cases” led to patients not being billed for COVID-19-related services, and that resulted in Northwell not receiving payments “to which it would have been entitled” for non-COVID-19-related services, she said.

At all three Northwell sites, outdoor signs promoted testing, photographs included in the settlement show.

At Huntington Hospital, Northwell posted a sign promoting drive-through “COVID Testing” in English and Spanish in the driveway of the main entrance.

Patients could receive tests while in their cars. Even so, patients were charged for an emergency room visit, the state said.

From June 8, 2020, to Nov. 12, 2020, those arriving for drive-through testing received a leaflet that stated, amid other text, “This is an emergency room visit and NOT a free service or county run testing site.”

But, the attorney general’s office said, some people still did not understand they would be billed for an emergency department visit.

At Lenox Hill Hospital, patients were asked starting Nov. 24, 2020, to sign a form that said the testing site was not a free service. At the Greenwich Village site, which includes a free-standing emergency department but is not a full-fledged hospital, a sign went up near the registration desk starting Feb. 29, 2021, stating that patients’ insurers would be billed for emergency department visits.

The wrongful charges were between March 2020 and April 2021, the attorney general’s office said.

As part of the agreement, Northwell also agreed to notify future patients seeking COVID-19 tests in emergency rooms that they will be charged standard emergency department fees. The May 2023 end of the federal COVID-19 public health emergency terminated the requirement for free COVID-19 testing.

The state’s investigation of Northwell began after patient complaints, and after a March 2021 New York Times story reported that patients at two of the three Northwell facilities were being charged the emergency-department fees for COVID-19 tests, according to the settlement.

Under the agreement, Northwell must refund $400,164 to 2,048 patients.

Of the 559 people who received only COVID-19-related services, the accounts of 30 were referred to collections, and led to $4,611 in payments. All of that money was refunded, and Northwell did not report the patients to credit agencies, the settlement says.

There were a number of cases nationwide of people illegally or inadvertently being charged for COVID-19 testing.

In July, the attorney general's office fined the New York City health clinic CareCube — which operated more than 20 COVID-19 testing sites in four boroughs — $300,000 for illegally charging patients for COVID-19 tests and obtained refunds for those wrongfully charged, James' office said.

Long Islanders were among those who complained of being billed hundreds of dollars by the nonprofit Westchester County-based Hudson River Healthcare after receiving COVID-19 tests in 2020 at churches and other pop-up sites. Hudson River said the charges were in error.

Northwell, which is a nonprofit, had an operating income in 2022 of $118 million on $15.568 billion in operating revenue.

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.