Are consumers being gouged on prices at RIOC’s Swift COVID testing site? According to information gleaned from a Kaiser Health Network report, they may be. And as Roosevelt Islanders foot the bills, profiteering appears to reach far beyond that. Here’s what we know, so far.
By David Stone
Lab companies have been booking record profits by charging $100 per test.Kaiser Health News
KHN’s report refers to a “molecular covid test that costs $50 or less to run.”
But RIOC’s site charges four times that much, $200 per test, and may be adding other charges. It’s transparent to those being tested because it’s passed on to insurers.
Castlight Health analyzed the costs of 1.1 million tests billed to insurers during the year ending in February. “The analysis found an average charge of $90.”
“Billing by hospitals and clinics from outside insurance company networks can be especially lucrative because the government requires insurers to pay their posted covid-test price with no limit,” KHN reported.
But RIOC’s Swift COVID rapid testing site may fall under a different set of guidelines. “Regulation for out-of-network vaccine charges, by contrast, is stricter. Charges for vaccines must be ‘reasonable,’ according to federal regulations, with relatively low Medicare prices as a possible guideline.”
The Medicare reimbursement rate, the standard for reasonable, is $100 per molecular test.
But RIOC and Swift may still be legal in charging double that, if not ethical.
The super secret state agency has not disclosed details of any possible profit-sharing with Swift, although they’ve repeatedly promoted the site and the $200 fee.
If consumers are being gouged on Main Street, it’s only part of the story because, as reported earlier, Roosevelt Islanders funded suspicious costs since the site’s start-up.
Are Roosevelt Island consumers being gouged from Day One?
In a peculiar presentation at RIOC’s April meeting, staffer Mary Cunneen asked for board approval of $319,750, compensating Swift Medical for managing the testing site. But although the board of enablers acted as if nothing was amiss, an apparent gap in purchasing was obvious.
RIOC spent that $319K apparently without required board approval, and no record exists of its legally mandated posting the State Contract Reporter. The Contract Reporter started in the 1990s as a tool for assuring bidding is public and fair.
What the board settled for is troubling. With a document in front of them claiming 3 competitive bids, the board didn’t blink when Cunneen raced past rejecting six Department of Health approved providers, going instead with Swift. Swift had no previous experience in running a testing center, and Cunneen offered no rationale for the decision.
Nor did she say who approved the expense.
A year ago, RIOC staff presented charts of bidding results, accompanied by justifications, when asking for award approval. But in the Shelton J. Haynes era, it’s different.
And it might be true that someone briefed the board privately in advance of the meeting, thereby skirting public disclosure.
But aren’t there protections against consumers being gouged?
Firewalls and Soba Noodles
As a kind of firewall, RIOC’s board is responsible for ensuring the state agency’s lawful operations. But as we saw in the Susan Rosenthal fiasco, they rarely do anything of the kind.
Consider the illustration above. RIOC’s board more closely resembles a bowl of soba noodles than the bulwark of proper firewalls.
Rosenthal sued each member individually for their miserable group failure at getting a spine during her firing. That case is pending in New York State Supreme Court.
Conclusion: Are Roosevelt Islanders and consumers being gouged and not just on prices?
With so much undisclosed by hermetic RIOC, answers are scarce, but the graver concern is nobody asking questions. The board, the fundamental layer of protection against misconduct, might as well continue its nearly year-long vacation from reality.
Elected officials? State Senator José Serrano hides out in the Bronx, and Assembly Member Rebecca Seawright evolved from a promising start to a high volume Cuomo/RIOC enabler. Neither challenges RIOC, Governor Cuomo’s local baby, and of course, the governor himself is awash is greater scandals.
In the next few days, The Daily plans on requesting complete details on how RIOC handled contracting with Swift, via a Freedom of Information request. Sunlight’s a good thing when it breaks the cloud cover protecting RIOC.
There is no clear evidence of any wrongdoing, but there’s enough smoke provoking a thorough search for anything burning inside the bunker.
The state agency, following Cuomo’s lead, however, has been glacially slow at answering FOIL requests and almost always leaves out significant details.
We’ll see what we get and when and keep our readers updated.
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