Dr. Rosenthal said “it’s time to call out this fact head-on” after listening to patient stories and analyzing several charges linked to treatment her husband received after a bike crash in July. In her husband’s case, most of the charges were covered by insurers at negotiated rates, and perfectly legal in the healthcare industry. Still, she said some of the bills he received wouldn’t be acceptable in other industries.
For instance, her husband received a neck brace in the trauma bay before physicians ruled out a spinal injury. The provider billed $319 for the equipment, which was used for an hour.
Dr. Rosenthal compared being billed for durable medical equipment, such as a neck brace or sling that can be purchased at Walgreens for a fraction of the price, to getting a “swag bag at a conference and then sent a bill for hundreds or thousands of dollars.” The upcharges are steep, and some of the equipment is never used once home, Dr. Rosenthal said.
She also noted current processes that allow physicians and other health professionals to bill at their rate for work stand-ins, like physician assistants.
“If an assistant did the work, shouldn’t it be billed for less? At law firms, the hourly rates for paralegals and junior attorneys are lower than those for partners,” she wrote.
Dr. Rosenthal acknowledged that “many of the charges that I would call fraudulent — maybe all of them — are technically legal (thanks sometimes to lobbying by providers), but that doesn’t make them right. And no one would accept them if they appeared on bills delivered by a contractor, or a lawyer or an auto mechanic.”
Read the full article here.
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