We recently talked about the unexpectedly high medical bills that many patients face after an emergency room visit. This is happening even to people who are go to an ER at a hospital that's in their insurance network because they may be treated by a doctor who's not in network. That can happen if insurers don't reach an agreement with ER doctors on their reimbursement rates, even if they have reached such a deal with the hospital.
A recent article in the New York Times about a man who was charged over $1,600 for an unexpected visit to an in-network hospital caught the attention of one U.S. senator who wants to do something to save patients from these "surprise" medical bills.
Florida Sen. Bill Nelson, who is the ranking member of the Senate Commerce Committee, wrote a letter to the Federal Trade Commission asking it to investigate this phenomenon. In his letter, Nelson said the practice, was "unfair and deceptive" because patients should reasonably expect that any doctor working at an in-network hospital would be considered an in-network provider.
Even if the FTC determines that the practice is unfair, it may not be able to change it. Insurance companies are generally regulated by state governments. Further, the FTC has no jurisdictions over non-profit hospitals, which many are. There is a possibility that the U.S. Congress could take action if enough legislators are so inclined.
As we noted before, many Americans are facing an uncertain future regarding their health insurance coverage as the Obama administration enters its final weeks. Patients can and should ask questions about whether the care they are receiving is covered. However, if you're in the ER with a burst appendix, a broken leg or a bout of food poisoning, you're likely in no condition to do that.
If, for whatever reason, you find yourself with medical debt that's beyond your ability to pay, you may be able to negotiate a lower fee or a payment plan with the provider. An experienced Arizona bankruptcy attorney can discuss your options with you.
Source: The New York Times, "Senator Calls for Inquiry Into ‘Surprise’ Medical Bills," Margot Sanger-Katz and Reed Abelson, Dec. 03, 2016