In the latest example of surprise medical billing gone very wrong, patients who require anesthesia for elective procedures – from dental fixes to more complex surgeries – often learn days after that they are victims of a surprise bill.
According to a recent report released in JAMA this year, researchers analyzed data from 350,000 patients and found that more than 20% got hit with a surprise bill after an elective surgery. One of the top culprits behind these excessive charges? Anesthesiologists.
According to the report, “anesthesiologists are often cited as the most common source of out-of-network bills in surgery” since patients usually don’t have a choice when it comes to picking a particular specialist. Of the claims analyzed, anesthesiologists were responsible for roughly 37% of the surprise bills with an average charge of more than $1,200. Keep in mind – a Federal Reserve report found that nearly 40% of adults in the United States in 2018 would have trouble paying an unexpected $400 bill.
The implications of these charges are very real. In October, a new report from the Government Accountability Office found that “on average, private insurers paid more than 3.5 times what Medicare paid for anesthesia services in 2018.” By refusing to participate in provider networks, anesthesiologists can charge patients thousands of dollars for out-of-network services, then turn around and demand equally high reimbursement if they choose to go in-network. It’s a trend that contributes to the rising cost of health insurance premiums across the country.
Congress knows how to fix this problem – and can take action. By aligning out-of-network charges with in-network rates, more than 100 million Americans would be protected from surprise charges from anesthesiologists and other out-of-network providers. This is the best and only way to close the market loopholes that allow private equity-backed providers and out-of-network specialists to take advantage of patients at their most vulnerable.
To learn more, click here.