Blue KC is Committed to Protecting Members from Abusive Billing Practices
Throughout the pandemic, Blue Cross and Blue Shield of Kanas City (Blue KC) has provided useful, timely and trusted information to members seeking COVID-19 resources and worked as quickly as possible to accurately process COVID-19 testing claims from providers. To date, Blue KC has completed processing and payment for nearly 510,000 COVID-19 diagnostic testing claims from approximately 1,300 providers.
Blue KC is a not-for-profit health insurance provider. We take reports of fraud seriously and proactively work to stop abusive billing practices that may drive up costs for our members.
As part of our ongoing due diligence in processing COVID-19 testing claims, we discovered one national provider, GS Labs, LLC, was engaging in price gouging and submitting bills with other serious concerns. For example, GS Labs demanded that Blue KC pay $380 for rapid antigen tests that cost less than $20 at wholesale. Many pharmacies provide this test without charge to the public. Other comparable providers in the area accept approximately $35 to administer this test. GS Labs demanded to be paid $380 for each rapid antibody test it administers. Other local providers charge between $38 and $45 for this type of test.
We worked in good faith to negotiate reasonable reimbursement rates with GS Labs and to investigate other discrepancies with GS Labs’ claims; however, GS Labs is not working with us in good faith. It continues to insist on unreasonable reimbursement rates.
On July 20, 2021, we filed a lawsuit in the United States District Court for the Western District of Missouri to prevent GS Labs from exploiting Blue KC and our members. This action seeks a judgment declaring Blue KC and our members are not required to pay GS Labs' unreasonable, inflated reimbursement demands.
We also want to assure our members that we are not billing them for GS Labs’ price gouging and we will continue to fight to ensure GS Labs cannot bill our members directly.
Efficient and effective testing for the virus is a key measure to restoring public health and ending the pandemic. We care about our employer groups, members and other partners, and will not stand for these exploitive billing practices.