Blue Cross and Blue Shield of Kansas City has sued a national COVID-19 testing facility, alleging GS Labs intentionally inflated its cash prices and performed unnecessary coronavirus tests in an attempt to fleece the not-for-profit insurer out of $9.2 million.
- Lawsuit: The AHIP insurance lobbying group said BCBS Kansas City’s suit represents the nation’s first payer complaint against a coronavirus testing provider. The insurer’s lawsuit comes as Washington D.C.-based powerhouse reports that payers across the nation are being “price gouged” by out-of-network COVID-19 testing centers, which are performing more diagnostic, antibody, and antigen tests than ever.
- Out-of-network clinicians: AHIP found that out-of-network clinicians administered 27% of coronavirus tests in March, a 6% increase from last April. The number of these providers charging at least 50% more than the commercial average for COVID-19 tests has doubled since the start of the pandemic, with 36% of out-of-network physicians pricing tests at above the standard rate.
- Testing claims: “GS Labs is intentionally engaging in an abusive scheme to exploit the COVID-19 pandemic by duping health insurers into paying thousands of COVID-19 diagnostic testing claims at grossly inflated rates,” BCBS Kansas City’s lawsuit reads.
- Claims and demands: GS Labs is demanding $380 for rapid antigen tests, while other comparable providers accept approximately $35, the payer claimed in the suit. Further, the test can be purchased for under $20 wholesale. In total, the testing company has submitted over $9.2 million in claims to Blue KC.
- Ways to restoring health: “Efficient and effective testing for Covid-19 is a key measure to restoring public health and ending the pandemic,” said Dr. Greg Sweat, senior vice president and CMO of Blue KC, in a news release. But, according to GS Labs, all the claims in the lawsuit are false.