Although Colorado passed a law last year limiting surprise medical bills, the law does not apply to air ambulances, which are regulated by the Federal Aviation Administration, reports The Denver Post. As a result, when a 4-week-old baby was taken to Children’s Hospital Colorado via air ambulance for an urgent surgery, the family was left with a medical bill of nearly $82,000, of which the insurer would pay only $18,000. Ultimately, the family worked with their insurer and the private air ambulance company to negotiate the bill down to $45,000.
Lorraine Rogge was billed $12,387 for a vaginosis, vaginitis and sexually transmitted infections testing panel after experiencing pelvic pain and cramping, according to Kaiser Health News’ Bill of the Month. Her insurer negotiated a rate of $7,172, of which the insurer paid $4,162 and Lorraine was responsible for $3,010. Although Lorraine’s repeated appeals to her insurance company were denied, after a call and email from Kaiser Health News, Carlsbad Medical Center agreed to waive the remainder of her account balance. The big takeaway is to always ask how much tests are going to cost and what exactly you are being tested for, especially when obtaining care from a new doctor.
Ohio has passed a new law to protect residents from surprise medical bills, according to The Center Square. The bill creates a baseball-style arbitration process between the provider and the insurance company—one that does not place patients in the middle. The legislation seeks to stop the practice of patients being charged for out-of-network services at the out-of-network rate when they are performed at an in-network facility.
Providing permanent housing with support services to people who have experienced chronic homelessness reduces healthcare costs, reports WBUR news. The results, from a study by Blue Cross Blue Shield of Massachusetts Foundation, show that expenditures by MassHealth (Massachusetts’ Medicaid program) were 11.2 percent lower for people in the first year they were housed than for a control group living in shelters and on the street. People living in permanent supportive housing have case managers from social service agencies who provide additional support. Indeed, MassHealth spent 35 percent more on mental healthcare for people who had experienced chronic homelessness in the first year they were housed, the study found, which suggests that those patients were getting needed help they had previously been missing.
Virginia will allocate $10 million in CARES Act funding to Unite Virginia, a platform that connects residents to health and social service providers, State of Reform reports. With the goal of achieving health equity in mind, Unite Virginia will allow healthcare providers to refer patients in need to support services within and outside of the medical field. These services include housing, food programs and other social services for Virginians in need.
A previous Wisconsin Watch/WPR investigation found that hospitals statewide sued dozens of patients during the early weeks of the pandemic, despite several hospitals pledging to pause or at least slow down aggressive debt collection during the public health crisis, reports Wisconsin Watch. However, one of those hospitals, Froedtert South, filed 314 lawsuits in small claims court against debtors in 2020. The lawsuits collectively sought to recoup about $1.1 million in alleged debt, ranging from $555 to $9,970 per lawsuit – at least eight defendants in 2020 filed for bankruptcy. Other Wisconsin healthcare providers have sued over debt in recent months, court records show, although Froedtert South stands out in volume.
A North Carolina task force established to address inequalities amplified by COVID-19 in communities of color has recommended looking at pressing public health issues such as “sick buildings” that can increase COVID spread, reports Costal Review Online. The problem of “sick buildings” is caused by legacy pollutants, such as radon, asbestos, mildew, and mold, that can arise from delayed maintenance of aging buildings, according to the task force’s first biannual report. The report notes that, “Nowhere is this problem more apparent than in NC’s public schools, especially those in hyper-segregated, concentrated poverty communities,” and that this issue disproportionately impacts communities of color. The report goes on to explain that because of aging and poorly functioning HVAC systems, children in “sick” school buildings are exposed to chemical and biological contaminants that adversely affect their health. The report also notes that these “sick buildings” with poor ventilation can also exacerbate COVID-19 by increasing its spread.
Colorado’s health insurance marketplace has launched a Public Benefit Corporation (PBC), which will offer healthcare ancillary products and services across the state and aims to increase consumer health literacy, according to Connect for Health Colorado. The PBC will also administer the plans and financial assistance, which will fund the state’s reinsurance program, provide financial help to people with low incomes whose net premium would increase as the individual market price for insurance decreases and set up a fund to provide financial help to people who don’t otherwise qualify under the ACA. The financial help will be in the form of a separate state-funded subsidy, available to people beginning in 2023.
UNC Health, North Carolina’s largest academic health system, has rolled out its new cost transparency tool via an app and on their website, reports North Carolina Health News. The tool makes it possible for consumers with or without insurance to estimate how much an office visit, simple procedure or inpatient service will cost. The tool results from a new rule from the Centers for Medicare and Medicaid Services (CMS), effective Jan. 1, 2021, in which all hospitals are required to provide public lists of standard charges for healthcare services in an easily accessible, easily searchable format. Transparency initiatives such as these, however, have had mixed success in getting patients to use them. For example, in 2007 New Hampshire created a website that provided negotiated out-of-pocket costs and negotiated prices for common procedures, but a 2014 study found that only about one percent of patients actually used the service over the course of three years.
Kansas has passed a number of policies to increase telehealth utilization as a result of the COVID-19 pandemic, according to a report by the Kansas Health Institute. Researchers identified several actions that state policymakers have taken, including: requiring payment parity for telehealth services; expanding services allowed under telehealth; allowing services to be provided via telephone, in addition to live video; and expanding allowed “originating” sites to include patients’ homes in addition to nursing facilities. Additionally, the Governor enacted multiple executive orders with provisions pertaining to telehealth, including licensure. Some of these provisions were later codified, allowing out-of-state physicians to treat Kansas patients via telehealth without securing a Kansas license, provided certain requirements are met. In the months and years ahead, Kansas policymakers must decide which changes should continue and whether additional changes are needed to encourage the appropriate use of telehealth.