Price gouging on COVID-19 tests remains a “significant problem” and Congress must take action to protect insurance providers and patients, America’s Health Insurance Plans argued recently.
AHIP, a national association representing provider and insurer interests, submitted a letter on Feb. 2 to the House Energy & Commerce Committee urging lawmakers to address the issue.
The association pointed to a survey of health insurers it conducted last year which found that out-of-network providers charged much higher prices for 54% of COVID-19 tests. In some cases, prices were $185 for a test that costs $130, on average.
“The data show that the problem has gotten worse—not better—since the beginning of the pandemic,” AHIP said in a statement.
AHIP suggested a handful of legislative actions to prevent further price gouging. These include allowing health insurers to bill out-of-network providers the median in-network rate for tests and directing the Centers for Disease Control and Prevention to publish guidance recommending the use of ICD-10 codes for COVID-19 tests.
The association also urged CMS to create Healthcare Common Procedure Coding System billing codes to track over-the-counter tests and to continue funding to ensure broad access to at-home tests.
“Health insurance providers are committed to working with Congress to pass legislation that eliminates price gouging and sets a reasonable market-based pricing benchmark for out-of-network COVID-19 tests, allows for appropriate tracking of tests administered and makes OTC tests universally available,” AHIP wrote in the letter.
Insurance companies and Medicare, including Advantage plans, are now required to cover the cost of eight at-home tests each month. Individuals can buy a test online or at a pharmacy and receive it either free of charge or get reimbursed by submitting a claim. The push is part of the president’s ongoing efforts to ramp up testing capabilities, which includes 500 million rapid tests purchased by the government that were sent out beginning Jan. 1.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.