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Insurance companies paid controversial Dr. Moma clinic for vaccines never administered

Colorado Springs, Colo. (KRDO) — Insurance statements are rolling in for vaccines administered at Dr. Moma Health & Wellness Clinic in Colorado Springs. It’s the same clinic where concerns over vaccine storage and possibly falsified medical charts prompted the state health department to confiscate thousands of doses.

The Colorado Department of Health and Environment advised patients vaccinated at Dr. Moma Health & Wellness Clinic to get re-vaccinated, deeming the doses administered there ‘invalid.’

Katie Sells got her first shot at the clinic before the state shut it down. Sells just noticed her insurance paid a claim to the clinic a couple of weeks ago.

“If they were deemed invalid, I don’t understand how she could even think that that was okay to put those charges through and request that payment,” said Sells.

Michael Seyfert was also vaccinated at Dr. Moma Health & Wellness Clinic. Similarly, he disagrees with the business billing insurance providers for COVID-19 vaccines that were ruled ineffective.

“According to the invoice, she was to be paid for services rendered, and I don’t think they were,” said Seyfert.

Other patients tell 13 Investigates they never actually got their COVID-19 shots at Dr. Moma, but the clinic billed their insurance anyway. Sean O’Hare sent 13 Investigates insurance documents confirming Anthem paid out part of a $41.18 claim for COVID-19 vaccines for him and his wife.

The couple did have vaccine appointments at the clinic, but the state confiscated the office’s vaccine supply before they could go through with their appointments. The insurance statement shows Anthem was requesting O’Hare and his wife pay the remaining $24.24 each, for receiving vaccines at an out-of-network provider.

Even if they had been vaccinated at Dr. Moma Health & Wellness Clinic, insurance companies should not be passing vaccine bills along to patients. That goes for vaccines administered at any location in Colorado.

“The vaccine is free. Neither insurance companies nor providers can bill a patient for a COVID-19 vaccine regardless of the circumstance. Providers cannot ask anyone to pay for the vaccine or other administrative costs, regardless of their insurance status. Providers are not allowed to turn people away because of an inability to pay or current medical coverage status. 

When CDPHE is aware of a provider billing a patient for the COVID-19 vaccine, we contact that provider to let them know they cannot charge patients for vaccines. Anyone who has been inappropriately billed by a provider can call our vaccine hotline at 1-877-CO VAX CO or file a report. Concerns about fraudulent billing would be referred to other appropriate federal and or state agencies for further investigation.

Generally vaccine providers can request reimbursement from a patient’s health insurance, but that provider should not bill the patient. And the insurance company should not bill the patient. If anyone believes that they are receiving a bill due to a problem with their insurance (e.g., the insurance is not paying the vaccine provider appropriately or on time, or the insurance company has made a mistake), the patient can contact the Colorado Division of Insurance to ask questions or file a complaint - 303-894-7490 / DORA_Insurance@state.co.us / doi.colorado.gov.”

Spokesperson | Colorado Department of Public Health & Environment

O’Hare now considers it lucky that his family missed receiving one of the invalid vaccine doses by just a few hours.

Sylvienash Moma tells 13 Investigates that her clinic billed the insurance of patients showing up in their system as vaccinated, indicating the system may not have accounted for patients whose appointments were cancelled. Moma says it was not her intention to bill for patients never vaccinated under her care.

Moma askes patients to email info@drmoma.org about any billing questions.

In addition, the Attorney General's office says it cannot confirm whether or not an investigation into the clinic has been filed.

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Lauren Barnas

Lauren is an anchor and MMJ for KRDO and 13 Investigates. Learn more about Lauren here.

Comments

3 Comments

  1. Between insurance companies trying to get out of paying for anything, and incompetent state oversight agencies, I’m not surprised that clinics like this are billing for services not provided to make up the difference.

  2. Most private practices have to contend with very slow payouts from insurance companies. It doesn’t justify fraud.

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