Congressional inquiries might not come too soon to revelations about predatory billing by large hospitals and hospital chains against patients for expensive care they received after being injured in wrecked vehicles.
The New York Times reported that its surveys have shown that patients, especially the poor and vulnerable, have too often been scammed over treatments their health insurance could have covered when they were involved in car crashes. Instead, hospitals and hospital chains seek to maximize profits – and supposedly protect themselves against financial loss – by making legal claims against the victims of the wreckage and their finances.
Claims, authorized by age-old practice, are called liens. This is a “legal claim on an asset, like a house or a settlement payment, to ensure that someone is paying off a debt,” The New York Times reported.
Why do this and not just take Medicare payments?
As the newspaper reports, by filing liens – which give institutions an early, priority claim on individuals’ assets – hospitals can also charge their highest rate for their care, typically sky-high prices that most patients don’t. never see because their insurers, including Medicaid and Medicare, negotiated better rates and would never pay cost.
Christopher Whaley, a health economist at the RAND Corporation that studies hospital prices, told the New York Times he couldn’t understand how institutions and chains could exploit the poor and injured in this way: price charged . It is absolutely unbelievable.
The newspaper, however, cited cases from coast to coast where patients with some form of health coverage found themselves chased by hospitals for payment for care they received after car crashes – even if they repeatedly inform institutions or chains to bill insurers. first. The stress of operating the stimulus is terrible for patients recovering from injuries, and it can be catastrophic for their finances and credit records, as one elderly Virginian found out, according to the New York Times:
Mary Edmison, an 86-year-old widow, said she tried everything to get Mary Washington, a hospital in Fredericksburg, Va., To bill her insurance – Medicare and private coverage – for the treatment she received during her treatment. ‘a 2016 accident. She called; she went to the hospital billing department; she sent a handwritten letter. “Over and over, I have asked Mary Washington to send their invoices through the proper channels,” she wrote in a 2017 letter. “I don’t know what their problem is. In August 2017, the hospital sued her for over $ 6,000. Ms Edmison, who has since settled the matter with the help of a lawyer, was shocked. “I’m on a fixed income and those kinds of charges would have sunk me,” she said. Eric Fletcher, a spokesperson for Mary Washington, declined to comment on Ms Edmison’s case, but said the hospital complied with federal and state privilege laws. “We never want a patient to experience hardship with medical bills,” he said.
But the newspaper reported that a Washington state hospital, in a 2014 lawsuit, found it generated $ 10 million in revenue through liens filed against poor and injured patients who could have been protected by Medicaid. Hospitals and chains have made the legal argument, with varying degrees of success in court, that they can and should force poor patients to pay treatment fees before they strike the government, which insists that ‘it would systematically cover car accident victims’ payments if they were billed.
The New York Times explained the privilege system:
“Many states have adopted [lien laws] at the turn of the 20th century, when less than 10% of Americans had health coverage. The laws were intended to protect hospitals from the burden of caring for uninsured patients and to encourage them to treat those who could not pay upfront. A century later, hospital liens are most often used to sue the debts of victims of car accidents. The practice can be so lucrative, according to documents and interviews, that some hospitals use outside debt collection companies to search police records for recent accidents to make sure they identify which of their patients might have been in a wreck, so they could sue them with privileges. Some laws limit the portion of patient payments a hospital can claim, and others only allow nonprofit hospitals to collect their debts in this manner. Some states require hospitals to bill accident victims’ health plans rather than using a lien. This approach is considered more user-friendly as patients benefit from the discounts that health plans negotiated on their behalf. “
The newspaper added this:
“When states have permissive hospital privilege laws, some hospitals take advantage of them in ways that harm patients. These hospitals tend to be wealthier, the New York Times found, and many of those that received hundreds of millions of dollars in federal rescue funds during the pandemic are among the most aggressive in pursuing payment by the through hospital privileges. Community Health Systems, which has 86 hospitals across the country, received about a quarter of a billion federal funds during the pandemic, according to data compiled by Good Jobs First, which studies government grants for businesses. One of his Tennessee hospitals refused to bill Jeremy Greenbaum’s Medicare or veterans’ health insurance after a car crash worsened an old combat ankle injury. Instead, the hospital filed for liens in 2019 for the full price of its care, according to records. “I could cut my finger and the VA would cover it,” Greenbaum said, adding that “the insurance is just that good.”
“The worst part,” said Mr. Greenbaum, “were the almost constant collection calls that made him feel like a“ real deadbeat. ”Mr. Greenbaum is now part of a lawsuit against the hospital, Tennova Healthcare Clarksville, which accuses her of abusive privilege practices. Ann Metz, spokesperson for Tennova, said that “Tennessee state law allows hospitals to file provider privileges to ensure that health care providers health can be paid for the treatment “.
Let’s see what happens if federal officials intervene. Representative Frank Pallone, Democrat of New Jersey and Chairman of the House Energy and Commerce Committee, made this comment on Twitter about the New York Times article:
“Accident victims should be able to focus on their recovery without fear of being exploited. @EnergyCommerce will get to the bottom of this – we need to protect patients from this blatant billing practice. “
In my practice, I see not only the harm that patients suffer when seeking medical services, but also the harm that can be inflicted on them and their loved ones by wrecked cars, motorcycles and trucks. . These incidents – which unfortunately happen all too frequently these days – can be traumatic and overwhelming, leaving victims weakened and in need of significant care for periods of time, up to and including the rest of their lives.
A common and shocking part of what victims and their loved ones experience begins, of course, when they have the least control over their lives – perhaps when they arrive at the hospital and are in desperate need of medical services. Patients and their families at this vulnerable time, however, can be bombarded by financial staff in institutions, demanding tons of information and signatures on piles of papers. The New York Times reported that some of the documents may be consent forms, allowing hospitals to impose privileges on patients for treatment fees, rather than billing their medical insurers.
Patients have learned from the horrific practice of surprise medical billing – in which they faced huge costs from providers outside of their health insurance company‘s “tight networks” of licensed caregivers – to do whatever it takes. that they could, given their state of emergency, to avoid signing documents in a hurry. Congress, unexpectedly and bipartisan, seems to have recently banned the worst parts of these surprise medical bills.
But the warning against putting your John Hancock on anything under medical duress can always be a wise one.
Here is another professional recommendation that may contradict preconceived ideas: patients should consider whether their first calls after a vehicle accident should go beyond their loved ones, perhaps not to their only insurance agent, but also maybe. -be to an experienced lawyer whom they trust. This can be particularly relevant if the injuries in a case are severe.
Conventional wisdom dictates that an auto insurance agent takes care of an insured after an accident. May be. It’s great if you have a solid gold pro like this.
But remember: agents work for insurance companies, you don’t. Your lawyer, as is the case with our firm, can step in to make sure your insurer is not trying to prevent you from getting the benefits you may be entitled to just to save their employer on expenses in your case.
Your auto agent certainly can’t help you if you find yourself in a battle with a hospital over their attempt to rip you off on your medical bills, especially if they are not your health coverage but a questionable slap in the face. privileges against you. or an aspect of your assets.
As the congressman said, all of this is sketchy and unacceptable behavior on the part of companies that should do better and in your best interests when you need their best the most. We have a lot of work to do to ensure that a road disaster does not turn into a financial nightmare for victims of vehicle wrecks.