New Study: Out-of-Network Providers are Price Gouging People who need COVID-19 Test

October 08, 2020

Some providers inflating COVID-19 test costs by 300 percent.

It’s hard to think of a health care practice more unprincipled and opportunistic than price gouging patients during a pandemic. Unfortunately, that’s exactly what’s happening at alarming rates across our country.

According to a new study, out-of-network providers are exercising a series of price gouging practices on COVID-19 tests.

They’re getting away with this by exploiting a loophole in the Coronavirus Aid, Relief, and Economic Security (CARES) Act passed by Congress in response to the pandemic.

When Congress was writing the CARES Act, it worked with insurers in others in the health care industry to make sure people could afford COVID-19 tests. Insurers agreed to cover the full cost of the test, including out-of-pocket expenses, so it was affordable for anybody who needed one.

Here’s the problem: when a provider is out-of-network they can charge whatever they want for the test and the law requires insures to pay for it in full. That means you, through your premiums, must pay these unchecked and potentially unlimited cost.

This wouldn’t be an issue if out-of-network providers charged an honest rate that is equal to the cost of the COVID-19 test in the regular commercial market.

But that’s not what’s happening.

The new report found that the average cost of a COVID-19 test in the commercial market is $130. But out-of-network providers are charging significantly higher rates – to the tune of $185 per test for nearly 40 percent of diagnostic tests and 25 percent of antibody tests. Worse, 10 percent of out-of-network claims clocked in at more than $390, or three times the average cost.

The COVID-19 pandemic has presented our country with an unprecedented situation that we’re all trying to navigate the best we can. The last thing we need are providers inflating prices, creating an unfair obstacle to patients receiving the care they desperately need.

Price gouging is wrong. Doing it in the throes of a pandemic makes it that much worse.

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