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DATE 2023-07-01

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Key: Value:

Key: Value:

MESSAGE
DATE 2023-07-27
FROM Ruben Safir
SUBJECT Subject: [Hangout - NYLXS] Blame the Doctors for Medical coss...
Doctor’s Office Care at Hospital Prices
Consolidation of medical practices brings dishonest billing that costs
patients and taxpayers billions.
By Bobby Jindal and Charlie Katebi
July 26, 2023 6:14 pm ET




42

Gift unlocked article

Listen

(5 min)


image
An exam room in San Jose, Calif., March 22, 2018. PHOTO: ELIJAH
NOUVELAGE/REUTERS
Each year millions of patients visit their doctors’ offices for a
variety of routine services. But in recent years more Americans are
being charged as if they had visited a hospital. This is because the
doctor’s office billing them is pretending to be a hospital.

When a hospital bills a patient’s insurer, it must report a federally
required National Provider Identifier number on the claim form to
identify where the care took place. Many hospitals use the same NPI
number for care that happens at a doctor’s office as at the main
hospital, allowing hospitals to add a facility fee and charge far more
than they would for a doctor’s visit.

In Ohio, one retiree was charged a $1,262 hospital facility fee for
receiving arthritis treatments in an outpatient clinic. The patient’s
share of the bill increased tenfold compared with what she had
previously paid for the same procedure provided by the same doctor in
the same building. In Colorado a patient was charged an $847 facility
fee for a telehealth consultation.

More Americans than ever are paying these dishonest fees as large
hospitals buy up the practices of local physicians. A report by the
Physician Advocacy Institute found that the share of hospital-owned
physician practices more than doubled, from 14% to 31%, between 2012 and
2018. By 2020 more than half of physicians worked directly for a
hospital or at a physician practice owned by a hospital, according to
the American Medical Association.

As a result, hospitals’ exorbitant facility fees have driven up the cost
of outpatient care. An analysis by the Committee for a Responsible
Federal Budget found that after a hospital buys a physician’s practice,
the price of numerous healthcare services—including MRI scans, drug
infusions and chemotherapy—doubles or triples.

Fortunately, states are working to protect families from the crushing
burden of dishonest medical bills. In May, Indiana Gov. Eric Holcomb
signed legislation requiring hospitals to disclose to insurers the
location where care is performed to ensure that hospitals are
appropriately billing patients and ensure patients aren’t billed for
surprise hospital facility fees.

In Washington, lawmakers are following Indiana’s lead and working to
enact common-sense hospital billing reform. The House Energy and
Commerce Committee and Education and Workforce Committee have passed
several measures to end dishonest billing nationwide. Like Indiana’s
reforms, these measures would require every off-campus facility within a
hospital system to have its own identifying number to help insurers
determine where patients receive care and crack down on facilities that
engage in dishonest billing.

A bipartisan group of lawmakers is introducing promising proposals to
bring similar reforms to Medicare through site-neutral payment reform.
In May, Sens. Mike Braun (R., Ind.), Maggie Hassan (D., N.H.) and John
Kennedy (R., La.) introduced legislation to equalize Medicare payments
between hospital-owned physician offices and independent offices.

Currently, Medicare pays hospital-owned facilities two to three times as
much as independent physician offices for the same service, according to
the Alliance for Site Neutral Payment Reform. This creates an enormous
incentive for large hospital chains to acquire outpatient practices.
Consolidation creates a vicious circle in which larger hospital systems
can demand ever higher rates from insurers and also have the capital to
buy up physician practices. Removing this perverse incentive will ensure
that patients have access to trusted doctors and appropriate care at the
same price regardless of treatment location and remove artificial
pressure to consolidate.

These bipartisan reforms would deliver hundreds of billions in savings
for families. Site-neutral payments would save taxpayers more than $153
billion in Medicare spending over the next decade and also substantially
reduce premiums and cost-sharing for Medicare beneficiaries by $94
billion, according to CRFB. In total, these changes could save patients
and taxpayers between $346 billion and $672 billion over the next decade.

Large hospital systems have exploited our nation’s outdated billing
systems to foist gigantic bills on Americans. Bringing much-needed
transparency in hospital billing will deliver more affordable care and
put patients back in control.

Mr. Jindal served as governor of Louisiana, 2008-16, and a U.S.
assistant secretary of health and human services, 2001-03. Mr. Katebi is
deputy director for the Center for a Healthy America at the America
First Policy Institute.
--
So many immigrant groups have swept through our town
that Brooklyn, like Atlantis, reaches mythological
proportions in the mind of the world - RI Safir 1998
http://www.mrbrklyn.com
DRM is THEFT - We are the STAKEHOLDERS - RI Safir 2002

http://www.nylxs.com - Leadership Development in Free Software
http://www.brooklyn-living.com

Being so tracked is for FARM ANIMALS and extermination camps,
but incompatible with living as a free human being. -RI Safir 2013
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