Optum accidentally charged 249 Medicare Advantage enrollees for the COVID-19 vaccine.
The New Mexico Superintendent of Insurance Office said that the UnitedHealth Group subsidiary accidentally charged enrollees $34 for the administration of the vaccine and $0.05 for the vaccine itself. An Optum spokesperson said the company is contacting anyone who was sent an invoice to tell them that they do not need to pay any fees associated with the coronavirus vaccine, and all members who have already paid the bill will receive a refund.
In a letter to the state on Jan. 29, Tim Godfrey, Optum's vice president of operations, said the error came from Change Healthcare, a revenue cycle management company that parent UnitedHealth Group acquired for $13 billion in January. Godfrey wrote that patients with and without insurance were charged for the vaccine. He said systems at Change Healthcare had been updated to reflect that the shots should be free, so no additional patients would be charged.
Angelica Anaya Allen, director of the consumer services division at the New Mexico Superintendent of Insurance Office, said she was not sure if the incident occurred across Optum facilities or if patients who received a specific type of vaccine were billed. But she said she hoped the mistake would not discourage residents from getting vaccinated. More than 20% of New Mexico residents live below the poverty line, and a lack of financial resources is a persistent issue blocking people from receiving medical care.
"It's unfortunate, given we are one of the poorer states in the country," Anaya Allen said. "The idea that people might be discouraged getting the vaccine when it's supposed to be provided without charge for is problematic."
She said the New Mexico Office of Superintendent of Insurance has also received a complaint about an uninsured person receiving a $44 vaccine administration bill from Holy Cross Medical Center in Taos. Holy Cross did not respond to an interview request.
Anaya Allen said the office was still working to resolve the issue with the consumer and Holy Cross.
"If an individual does not have health insurance, or even if they do have a form of insurance like Medicaid, they may not have the money to pay if they think they have to pay upfront for the vaccine," Anaya Allen said.