The health and well-being of millions of Americans remains AHIP’s highest priority. From the early days of the pandemic, health insurance providers engaged to support COVID-19 testing, taking decisive action to cover the costs of provider-prescribed diagnostic tests to diagnose and treat COVID-19 – and we continue to do so.
Today, AHIP submitted a statement for a hearing in the House Committee Energy and Commerce Subcommittee on Consumer Protection and Commerce entitled “Pandemic Profiteers: Legislation to Stop Corporate Price Gouging” which focused on the widespread problem of price gouging during the COVID-19 pandemic, particularly as it pertains to COVID-19 testing.
The statement notes that price gouging in COVID-19 testing continues as a significant problem:
“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 found 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. The data show that the problem has gotten worse - not better - since the beginning of the pandemic.”
The statement also highlights legislative actions Congress can take to prevent price gouging during the pandemic:
- Protect patients from “balanced billing” by permitting health insurance providers to base payment for COVID-19 tests administered out-of-network on their median in-network rate.
- Instruct the Centers for Disease Control and Prevention (CDC) to release guidance permitting the use of the ICD-10 COVID-19 screening test code.
- Instruct the Centers for Medicare & Medicaid Services (CMS) to create HCPCS billing codes to create a systematic mechanism for tracking over-the-counter (OTC) tests.
- Continue federal funding for broad-based access to OTC COVID-19 tests.
The statement closes with health insurance providers pledging to work with Congress to put protections into place to stop price gouging:
“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.”
Please click here to view the statement.