Hospitals fail to tell uninsured COVID-19 patients their bills are covered, NPR finds

Most major health systems participate in a program that covers hospital bills for uninsured COVID-19 patients; however, many of them are not telling their patients upfront, according to NPR.

The program is run by CMS and was set up by the Coronavirus Aid, Relief and Economic Security Act this spring. 

According to Jennifer Tolbert of the Kaiser Family Foundation, who studies uninsured patients, there is no requirement for hospitals to tell uninsured COVID-19 patients upfront that the federal government would pay the bill in full. Ms. Tolbert also said that even physicians don't always know how the program works or that it exists. She says these are shortcomings of the program. 

Ms. Tolbert's research finds that people without insurance often avoid care for financial reasons, even though they may qualify for a number of financial aid programs.

"At the point when the patient shows up at the hospital or at another provider site, it's at that point when those questions need to be answered," Ms. Tolbert told NPR. "And it's not always clear that that is happening."

An investigation into the case of Darius Settles, a 30-year-old uninsured patient who died from COVID-19 in July, found he had never been told that cost shouldn't be a concern. 

Mr. Settles took two separate trips to TriStar Southern Hills emergency room in Nashville, Tenn., as his symptoms worsened. He was sent home the first time with antibiotics and awaited COVID-19 test results. The second time, he knew he had COVID-19, but was not admitted to the hospital because after a few hours in the ER his oxygen levels improved and he was otherwise young and healthy, and the physician didn't note any other risk factors for complications. 

However, although he needed it, he never made a third trip to the hospital. Instead of calling 911, he called his father, pastor David Settles, and asked him to come pray for him.

Shortly after his father arrived, Mr. Settles became unconscious. At that point his father and wife, Angela Settles, called 911. They were told to perform chest compressions. Even after help showed up, Mr. Settles never woke up. 

According to Ms. Settles, TriStar never told her or her husband that the hospital bill would be covered under the program, according to the report. 

Even after failing to disclose its policy for uninsured COVID-19 patients, TriStar sent Ms. Settles a bill for part of her husband's care. A TriStar spokesperson said that the bill was sent in error. 


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