By Sarah Kliff
As Congress moves to address one of the most devastating public health crises facing the country, patients, consumers and families continue to be slammed with surprise medical bills related to COVID-19 care and treatment. The latest New York Times piece highlights the loopholes in the current protections, underscoring the urgency for Congress to include comprehensive safeguards from surprise medical billing in the next legislative package:
- “When Debbie Krebs got the bill for a March emergency room visit, she immediately noticed something was missing: her coronavirus test.”
- “The absence of the coronavirus test made a big price difference. Insurers, Ms. Krebs had heard, were not charging patients for visits meant to diagnose coronavirus. Without the test, Ms. Krebs didn’t qualify for that protection and owed $1,980. She called the hospital to explain the situation but immediately ran into roadblocks.”
- “Across the country, Americans like Ms. Krebs are receiving surprise bills for care connected with coronavirus. Tests can cost between $199 and $6,408 at the same location. A coming wave of treatment bills could be hundreds of multiples higher, especially for those who receive intensive care or have symptoms that linger for months. Services that patients expect to be covered often aren’t.”
- “The federal government has since resolved to give Americans special protections against outlandish medical bills. Congress enacted new rules to make the tests a rare oasis within the American health care system — the price had to be public; and co-payments, deductibles or other charges weren’t allowed.”
- “Or at least, Congress tried to. The experiences of patients who had or suspected they might have Covid-19 show how hard it is to write different billing rules for a tiny sliver of the country’s $3 trillion in health spending. Numerous doctor’s offices and hospitals do not post the cash prices for their coronavirus tests, despite the federal requirement to do so. Some patients have encountered unwarranted co-payments as doctors and hospitals have stuck to their regular billing habits”
- “Aside from mandating that Covid-19 tests cost the patient nothing, there are no new rules to protect insured Americans from coronavirus treatment bills.”
- “Health policy experts worry that even those with good insurance could end up facing high costs. One outcome they envision: A patient goes to an in-network hospital for coronavirus treatment, but that hospital is overwhelmed and has no beds left. The patient is transferred to an out-of-network hospital, and gets significant bills as a result.”
- “The Kaiser Family Foundation estimates that a fifth of all coronavirus hospitalizations could result in a surprise medical bill from an out-of-network doctor who became involved in the patient’s care. The nonpartisan foundation also projects that, on average, an American with employer-sponsored coverage would face $1,300 in costs for a coronavirus hospitalization.”
- “Congressional staffers working on the issue say they’ve come across cases in which health providers are not following the new rules on coronavirus billing. The providers are charging patients for services when they shouldn’t, or not posting their cash prices for testing online as they are legally required to.”
Without immediate action, consumers and families remain financially exposed to surprise medical bills from out-of-network providers and private equity firms. At a time of financial uncertainty for many Americans across the nation, Congress needs to put a permanent stop to this predatory practice and end surprise medical billing once and for all.
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