The New York attorney general’s office settled with Centene subsidiary Fidelis Care to refund members who improperly paid for COVID-19 testing visits and some HIV screening services.
Under the settlement, Fidelis reprocessed “tens of thousands of claims,” paid more than $2.8 million to providers, confirmed providers canceled bills, refunded patients and modified its internal systems, according to a Dec. 18 news release from the attorney general’s office. The insurer will also pay $175,000 as a penalty.
An investigation determined Fidelis required patients to pay out-of-pocket costs for services intended to be free under the law. Between October 2021 and August 2022, providers improperly charged for more than 38,000 office visits related to COVID-19 testing. Providers also charged for more than 2,800 HIV screening services between January 2022 and May 2023.
Fidelis can be fined up to $500 for each violation going forward.
The insurer previously has come under scrutiny from the New York attorney general: In 2024, Fidelis had to pay $7.6 million for using a banned Medicaid provider.
Becker’s has contacted Fidelis for comment and will update this story if more information becomes available.
