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Tuesday, April 14, 2020

Stimulus package bars hospitals and doctors from engaging in surprise billing

The recently signed stimulus package bars hospitals and doctors from sending "surprise billing" to covid-19 patients, Ricardo Alonso-Zaldivar reports for The Associated Press. The government has also pledged that all covid-19 testing and treatment will be free.

The measure, which was not included in the stimulus package, addresses a loophole that has been deviling many patients. On March 11, President Trump announced that health insurers had agreed to waive co-pays for covid-19 treatment, but many people were still getting hit with sky-high ER and lab testing bills since that treatment happened before the patient was diagnosed. One woman was charged $28,000 for a throat swab sent to an out-of-network lab, Elisabeth Rosenthal and Emmarie Huetteman report for Kaiser Health News.

The issue highlights the financial risk that many patients undertake when they go to the ER, mostly because of out-of-network doctors or testing labs at in-network hospitals, Sheelah Kolhatkar reports for The New Yorker. Kolhatkar's piece, though lengthy, is well worth a read, as it shows how private equity firms are largely behind the phenomenon of surprise billing.

Specific language barring surprise billing may be included in the next stimulus package. Some lawmakers wanted to included such language in the first package, but the notion "triggered expensive lobbying campaigns by moneyed health interests and private equity companies with stakes in firms that staff hospitals with physicians," Susannah Luthi reports for Politico.

The air ambulance industry, which rural areas rely on heavily, was involved in efforts to keep surprise billing language out of the final package. Lobbyists "played what a person familiar with the negotiations, who spoke on the condition of anonymity, called 'the COVID card': 'How could you possibly ask us to deal with surprise billing when we’re trying to battle this pandemic?'" Rosenthal and Huetteman report.

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