NEW YORK (360Dx) – Quest Diagnostics and Laboratory Corporation of America are being sued for allegedly overbilling patients for diagnostic tests.
In separate complaints filed in federal courts in New Jersey and North Carolina in March, the plaintiffs' lawyers said that Quest and LabCorp billed patients "fees far in excess of the market rates negotiated at arm's length with third-party payers, such as insurance companies," Wolf Popper, the plaintiffs' law firm, said in a statement. "Plaintiffs had no agreement with the respective labs, and when their insurance companies did not pay their claims, the labs unilaterally charged them excessive, nonmarket-based rates."
One lawsuit cites the example of Marvin D. Leslie and his wife Vick Leslie, who were each billed $328.85 by Quest for an MTHFR genetic test done in November 2013. Their insurer, Aetna, denied coverage for the tests, saying they were "experimental or investigational." Had Aetna reimbursed Quest, however, according to the lawsuit's complaint, the insurance company would have "reimbursed Quest ... substantially less than the $328.85" that the Leslies were billed.
In the complaint filed against LabCorp, plaintiffs' lawyers noted the example of Victoria Bouffard, who was charged $616 for a vitamin D test. Bouffard received six other tests, which her insurer covered, paying LabCorp $63.65 for those tests, or just 17 percent of the aggregate rack rate of $370. Her insurer, Horizon BlueCross BlueShield of New Jersey, however, did not cover the vitamin D test, and LabCorp billed her the full rack rate, $616, for it.
"Had [Bouffard's] insurer covered the test, the cost would have been substantially less," according to the complaint.
A LabCorp spokesperson said that the firm doesn't publicl comment on pending legislation, "but we believe our billing and pricing practices are lawful and we intend to vigorously defend this lawsuit."
Quest did not respond to a request for comment.
In both cases, plaintiffs' lawyers seek class action certification. They also are asking the courts for damages, permanent injunctions against both firms from continuing to overcharge patients for diagnostic testing, and other relief.
The lawsuit against Quest was filed in US District Court for the District of New Jersey, while the lawsuit against LabCorp was filed in US District Court for the Middle District of North Carolina, Greensboro Division.