MANCHESTER – City officials are looking into why a visit to the bone marrow registry kiosk at the Mall of New Hampshire costs the city insurance fund more than $4,000 when the going price at other registries is about $100.
Mayor Ted Gatsas contacted the state Attorney General’s Office this week about the questionable billing after two people covered by the city’s medical insurance visited the Caitlin Raymond International Registry mall kiosk and reported a combined bill of $8,400 for the bone marrow mouth swab tests.
According to Gatsas, kiosk employees told potential donors the “cost to their insurance plan was minimal.”
Joanne Raymond, executive director of the Caitlin Raymond International Registry, said she has spoken to the mayor about the charges and has agreed to reimburse the city.
“I have found that there were slightly over 100 people since we’ve been doing this that are employed by the city of Manchester,” said Raymond. “We will notify the lab to reverse the insurance claim and we’ll take care of them. They’ll bill us.”
The city estimates this reimbursement could be more than $544,000, but the question still remains why the charges were so high in the first place.
Reviewing the charges
In a letter to the Human Resources Department, Gatsas requested a multiyear review of the charges submitted for the human leukocyte antigen (HLA) test and an explanation of these charges. He also asked a letter be sent to all city employees explaining the high cost of these tests.
The charges were brought to the attention of the mayor’s office by two city employees who noted the test listed on their insurance explanation of benefits statement. Although the employees were not charged, the city, which operates a self-funded health insurance system, paid the cost.
According to materials distributed by the Caitlin Raymond International Registry, it forwards test samples to a laboratory contracted by the donor’s insurance company. The lab then bills the insurance company “according to its standard charges” and the insurance company pays the lab “to the rate schedules it has established in its contract.”
The labs and insurance companies set the high rates, not the registry, said Raymond, and these rates can vary depending on a donor’s coverage.
Anthem’s response
Anthem Blue Cross and Blue Shield in New Hampshire handles administration of the city’s medical insurance and would be the firm to negotiate acceptable medical procedure charges. In a statement issued Wednesday, Anthem Director of Corporate Communications Christopher Dugan said the company “is very concerned about this issue.”
“We believe that the information the provider is sharing about the cost to our members is both inaccurate and misleading,” Dugan said. “We are conducting a thorough review and are working as quickly as we can toward resolution. As soon as we have completed our review, we will be following up with all of our customers who were affected by this issue.”
Costs passed on
The Caitlin Raymond International Registry, affiliated with UMass Memorial Medical Center in Worcester, Mass., was formed in 1986 after the death of Raymond’s daughter, Caitlin. To date the organization has signed on 180,000 potential donors. The registry receives about 600 requests for donors each month and has about 4,000 to 6,000 people who at any time are waiting for a match, according to Raymond.
The registry takes swab samples, sorts out ineligible donors based on age and medical history then sends the swabs to a contracted lab, usually its affiliated UMass laboratories, Raymond said. The cost of the tests are passed on to the insurance companies, which New Hampshire and Massachusetts require they cover. Because of this state insurance requirement, it is easy for the average customer to overlook the actual cost.
Other bone marrow registry non-profits, such as the National Marrow Donor Program, use donations to defray some of the cost for donors. Spokesperson Catherine Scott said the National Marrow Donor Program asks potential donors to contribute $100 for testing costs, though this is just a suggested donation.
Provocatively dressed
Gatsas said Wednesday night that the city is continuing to investigate the source of the high charges and will continue to pursue this issue to ensure the city is reimbursed.
The mayor’s office has also fielded questions about how the registry operates its kiosks, particularly reports that attractive and provocatively dressed women have conduct the swab tests at the mall kiosk and city events.
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