Do They Or Don’t They? It Sure Looks Like Private Equity Firms Balance Bill Consumers

Recently, the private equity companies behind the most egregious surprise billing practices have tried to distance themselves from their bankrupting charges. They say they aren’t balance billing patients, but their actions suggest the exact opposite. We’ve been keeping track.

• Private equity-backed firm, TeamHealth, says it has a “long-standing policy against surprise billing.” Yet Axios reported that the company has sent thousands of surprise bills to patients over the past two years, even  suing patients who didn’t pay according to ProPublica.
• Private-equity backed firms and providers have established a successful business model of balance billing patients, often operating outside of insurance networks. Not surprisingly, Envision tried to tout its “in-network” status but the New York Times highlighted how the company frequently takes over physician practices in local communities, breaks contracts with insurers, and then demands a blank check. As a result, costs for emergency care skyrocket when Envision comes to town – almost like a “light switch was being flipped on.” According to recent research of filings from a large commercial insurer, Envision has “routinely operated outside the insurance networks of hospitals where their doctors practice…often leading to surprise bills for patients.”
• Both companies claim to be on board with surprise billing reforms, but have spent millions – roughly $40 million to date – to pressure Congress to give them a surprise billing bailout with proposals for arbitration and independent dispute resolution (IDR).
• If Congress is serious about stopping surprise medical bills, a fair, market-based benchmark is the only way to do so. A benchmark would:
  • Protect consumers from egregious charges from out-of-network providers and private equity firms;
  • Improve access to quality, in-network care for millions of Americans;
  • Provide employers and taxpayers billions in cost-savings ($25 billion to be exact);
  • Avoid a costly, burdensome arbitration process that would give private equity firms the upper hand.

It’s time for Congress to put patients before private equity firms and stop surprise medical bills.