By: TAHP | Wednesday, February 16, 2022

February 16, 2022

By: Blake Hutson

Throughout the COVID-19 pandemic, Texans have been tricked into a new type of health care price gouging – outrageous COVID-19 testing. The problem came from a perfect storm of state and federal government regulations that paved the way for some of the worst kinds of price gouging seen in health care. 

New rules released in January now require health plans to cover the cost of at-home tests and the nation’s health insurers are  calling for action against price gouging . While the new requirement for at-home test coverage does come with a maximum reimbursement cap of $12 per test, many retailers quickly  moved prices up  to that amount and still others are price gouging at  much higher prices . 

Health insurance providers will continue to do their part to help stop the unnecessary spread of COVID-19, but regulators and policy makers cannot turn a blind eye to abuses from some providers.

In Texas, even before COVID-19, freestanding emergency rooms  were routinely price gouging for services . The general scam is the facilities look and act a lot like urgent care centers. These ERs then lead patients into believing they are in-network with insurance companies and not to worry about the cost. The result is patients go to very high cost out-of-network emergency rooms for minor illnesses and end up with enormous charges. COVID-19 created the opportunity for a whole new scheme and huge pay day for these bad actors. 

As a part of the federal CARES Act, Congress required health insurers to cover the full cost of testing for COVID-19 without any co-pays or other out-of-pocket costs. Everyone agreed that consumers shouldn’t be deterred from seeking a COVID test because of the cost, but the policy breathed new life into the bad actors behind these freestanding ERs. 

What followed has been story after story of patients hit with thousands of dollars in charges for COVID testing at freestanding ERs. Like Diana Vasquez who was  billed over $15,000  for her test at a freestanding ER in Corpus Christi. Or Travis Walker, who by our latest count, has the  record for a COVID test bill at over $56,000 ! 

Even after the passage of a new state law aimed at rooting out the price gouging, Texans are still reporting the problem going into 2022. In this recent google review of a “Elite Care ER in Rice Village” the woman writes:

“Please beware of Elite Care ER in Rice Village. They are a scam! I went in for a rapid antigen COVID test and they billed my insurance for 2 ER visits.1 bill was for $1600+ that came from a Dallas PO Box, which is sketchy. The second bill for $400 was from Houston, but neither bill named Elite Care ER. This is frightening. How do they get away with this?”

If you’re looking for a COVID-19 test avoid the freestanding ERs and watch out for the online price gougers and even fake tests. While insurers are picking up the cost of most of this price gouging, these costs threaten health care affordability for businesses and families.