Northwell hospital charged 30x more for COVID-19 tests in its ED

Lenox Hill Hospital in New York City, part of Northwell Health, charged patients more than $3,000 for routine COVID-19 nasal swab tests in its emergency department, which is roughly 30 times higher than the cost of a typical test, according to The New York Times

According to patient medical bills reviewed by the Times, the Lenox Hill Hospital charged a test fee that was six times higher than the amount of a typical test and also billed for a moderately complex ED visit. 

One family told the Times its bills contained charges amounting to $39,314 for 12 tests taken to meet requirements to return to work and school this past winter. In another instance, an asymptomatic patient walked into the ED after seeing a banner outside advertising the COVID-19 tests. Her insurer was then charged $2,963. 

Federal legislation requires COVID-19 testing to be free for patients, and none of the patients tested at the Lenox Hill ED were billed for the service. But the Times said that American patients will bear the cost of these tests in the form of higher insurance premiums. 

Northwell, based in New Hyde Park, N.Y., told Becker's Hospital Review that the health system is required by federal law to evaluate and treat any patient presenting to the ED for any service, including COVID-19 testing. 

Additionally, Northwell said patients requesting a COVID-19 test in an ED "are clearly informed — both verbally and in writing — that it is considered an emergency visit due to the need for a physical exam and evaluation of their medical history."

The notice from Northwell also informs patients that they will not be on the hook for copays or out-of-pocket expenses for the COVID-19 test and that their insurance will be charged for the emergency visit. The health system also provides patients with resources to locate a free testing site in New York.

Northwell said that the payments it receives from these visits are based on Medicare or Medicaid payment rates or the ones negotiated with commercial insurers and said that neither patients nor insurers pay the charges listed on the explanation of benefits notices sent to patients by insurers.  

"Whether it be through the more than 45 vaccination sites that Northwell now operates, including many in underserved communities, or the continued development of new tests to identify COVID variants, Northwell has demonstrated an unwavering commitment to our communities throughout this pandemic. It's regrettable that this story misrepresents our mission," Northwell said. 


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