AHIP, the national association whose members provide health care coverage, services, and solutions, has claimed that federal mandates asking insurers to pay for Covid-19 tests have led to price overcharging by some out-of-network providers. The association said that out-of-network providers charge significantly higher prices.
- Out-of-network providers ‘charged’ 54% more for tests: Making these submissions before the House Committee Energy and Commerce, Subcommittee on Consumer Protection and Commerce, it said, “In 2021, AHIP conducted a survey of health insurance providers in the commercial market to gather information on prices charged by out-of-network providers for Covid-19 tests. The results showed that out-of-network providers charged significantly higher prices (more than $185 when the average is $130) for more than half (54%) of COVID-19 tests.”
- Urgent need for Congress to act: The insurers body has urged Congress to act against such practices by eliminating the federal requirement that insurers pay the ‘cash price’ for Covid-19 tests delivered out-of-network. It has also urged Congress to instruct the CDC to release guidance permitting the use of the ICD-10 Covid-19 screening test code. This would allow insurers to implement testing policies and more precise coding, AHIP said
- AHIP recounts its contribution: The organization emphasized that the well-being of the American public remains its primary concern. It said that since the beginning of the pandemic, health insurance providers have been engaged to support Covid-19 testing, acting proactively to cover the costs of provider-prescribed diagnostic tests to diagnose and treat Covid-19 – and that continues even today.
- The underlying cause of over-charging for tests: The insurers body submitted that Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act last year, which requires health insurance providers to pay the listed cash price the provider has posted on a public web site for tests to diagnose Covid-19 when there is no contract in place. This has resulted in health insurance providers getting handicapped in negotiating more affordable testing prices. This has led to health insurance providers experiencing widespread price gouging associated with lab-conducted Covid-19 tests.
- Extends supports to Federal funding: AHIP expressed its support to the continued federal funding for broad-based access to OTC Covid-19 tests. The universally-available program established via the US Postal Service has been very popular and implemented extremely efficiently. It also suggested its expansion to ensure that everyone regardless of coverage type gets access to free Covid-19 tests during the period of the public health emergency.