Katie Porter (CA-45), sent a letter to President Biden calling on his Administration to take additional steps to reduce the cost and overall accessibility of diagnostic COVID-19 testing. Although the Biden Administration now has a website for residents to get mailed free tests, the representatives stressed the need to increase accessibility in other areas.
As the United States reached a record of 650,000 daily cases of COVID-19 early this month, the virus’ surge is forcing more Americans to seek testing. The Representatives commended the President’s recent actions to increase diagnostic testing, including launching additional federally run testing sites and purchasing one billion rapid tests for distribution to Americans, while expressing their serious concerns that unexpected costs and barriers are causing patients to pay for testing that should be free—or to forego testing altogether.
“We urge the Administration to use all the tools at its disposal, including its emergency powers, to guarantee that diagnostic testing is provided at no cost to patients” the lawmakers wrote. “Widespread testing is one of the most important tools for transitioning the public health emergency pandemic to an endemic phase. As demand for testing makes appointments scarce and forces some patients to pursue fee-based testing that costs hundreds of dollars, officials are warning of price gouging for at-home tests.”
Congress has repeatedly authorized funding to cover costs associated with testing uninsured patients. However, uninsured patients receiving lab testing have still encountered unexpected bills.
“Except in limited circumstances, these laws require group and individual insurance plans to cover diagnostic testing without passing costs on to patients,” the representatives wrote. “Despite your Administration’s guidance, it appears that some providers have billed patients for tests not deemed ‘medically necessary.’ Other reports highlight that patients have received bills for screening services associated with, but unrelated to, their COVID-19 testing. These fees stem from services like doctor consultations or screenings that providers proactively offered patients; the patients did not request these tests.”
The Representatives requested a briefing on a number of issues affecting their communities, including surprise billing for medically administered COVID-19 tests, price gauging for at-home tests, deceptive and fraudulent billing practices, rising test prices, and the Administrations planned insurance reimbursement system for privately purchased tests.
Additionally, they specifically called on the Administration to:
- Ensure that testing facilities are complying with federal guidance that ensures that that medical management not be used in evaluating whether tests are “medically necessary;”
- Work with providers to streamline insurance reimbursement for both PCR and rapid (antigen) tests, and to require that reimbursement claims cannot be denied due to delayed claim submissions;
- Pursue criminal penalties against testing providers that engage in fraudulent billing practices;
- Develop a toll-free hotline as a supplement to the online at-home antigen test distribution website to ensure that those without access to the internet can still access free government at-home tests;
- Require insurers to cover the costs of antigen tests at no cost-sharing to patients;
- Continue to expand federally run testing facilities; and
- Use federal emergency powers to provide no-cost testing to anyone who seeks a diagnostic test for personal purposes.
The full text of the letter can be read here.