December 15, 2022
Premera filed a lawsuit on October 14, 2021, against GS Labs LLC alleging abusive pricing and billing practices. While that lawsuit is still ongoing, Premera has elected to release and/or reprocess GS lab claims to either deny or pay using comparable contracted reimbursement rates. Members will receive updated Explanation of Benefits (EOB) reflecting the adjustment of a previous claim, which may show an amount as member responsibility. Note that members are receiving an EOB, which may show a balance due from the member. This is not a bill, and the member does not need to pay GS Labs unless they receive an actual invoice directly from GS Labs.
Under the Federal COVID mandates, health insurers are required to cover COVID tests when they are done due to symptoms or exposure. In some cases, two or three types of tests were done, when only one was necessary (PCR, antigen, and antibody). In those situations, only the PCR test is covered, as it is the more sensitive of the tests. Antibody tests are not covered under the COVID mandate. Additionally, tests done for return to work, return to school, or sports, are not covered.
We expect all claims that have been held to finish processing in January.