House Subcommittee Holds Hearing on Hospital Billing, Collection Practices for Uninsured Patients
The House Energy and Commerce Subcommittee on Oversight and Investigations on Thursday discussed findings of its yearlong investigation of for-profit and not-for-profit hospitals' billing and collections practices, CongressDaily reports. The investigation found that overall, hospitals were charging uninsured patients "by far the highest rates of any segment of the population," according to CongressDaily (Rovner, CongressDaily, 6/25). Subcommittee Chair Jim Greenwood (R-Pa.) said, "An average working man or woman treated at a hospital can be stuck with a bill that is double what managed care or government programs pay. Then, to add insult to injury, they are sometimes aggressively pursued for these inflated debts. This situation is unfair and unjust."
According to Dr. Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins University, hospitals typically charge uninsured patients two to four times as much as patients with health care coverage because of discounts negotiated with insurers (Jakes Jordan, AP/Denver Rocky Mountain News, 6/24). Melissa Jacoby of the University of North Carolina School of Law said that some hospitals with policies in place to help uninsured patients pay for their care still "try to get money first and ask about eligibility [for aid programs] later." Several hospital executives testified that they have modified their billing policies since the investigation began, partly because HHS clarified that hospitals can extend discounted rates to uninsured patients without violating Medicare and Medicaid regulations (CongressDaily, 6/25). In a February letter, HHS Secretary Tommy Thompson wrote, "Nothing in the Medicare program rules or regulations prohibit such discounts" to the uninsured. Thompson also said that hospitals should "take action to assist the uninsured and underinsured, and therefore end the situation where, as you said in your own words, uninsured Americans and others of limited means are often billed and required to pay higher charges" (California Healthline, 2/20).
Hospital officials testified that they are in a "cash crunch" because of the growing costs of indigent care, and some suggested solving the problem by implementing universal health care coverage, the AP/Rocky Mountain News reports (AP/Denver Rocky Mountain News, 6/24). Democrats on the panel agreed that the problem extends beyond the hospital billing system. Rep. Diana DeGette (D-Colo.) said, "It would be easy for this body to simply blame hospitals for over-aggressive bill collection. But that would miss the larger point: Too many Americans are unable to pay for health services because they do not have health insurance." Meanwhile, on Tuesday the House Ways and Means Subcommittee on Oversight held a hearing on whether not-for-profit hospitals are providing sufficient charity care to justify their tax-exempt status (CongressDaily, 6/25). Over the past two weeks, trial lawyers have filed suit against more than 20 hospitals and health systems alleging that the institutions violated their obligation as charities by overcharging uninsured patients (California Healthline, 6/23).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.