Happy New Year!!!!
If you’re a first-time visitor – WELCOME!
If you’re a returning visitor – WELCOME BACK!
2022 is off to a rather interesting start. Here are just a few things that have already happened.
Hospital Price Transparency – UPDATE
The federal law known as the Hospital Price Transparency Rule, which requires hospitals to disclose their prices, has been in effect for over a year. But many hospitals have not complied with the rule. While the U.S. Centers for Medicare & Medicaid Services (CMS) recently issued warnings to more than 300 hospitals, not a single one has been penalized by the agency, according to a December 30th report from the Wall Street Journal.
Two-million dollars is the maximum penalty.
Frankly, it doesn’t make sense for a hospital not to reveal its prices when a similar law for insurance carriers and self-insured groups – Transparency in Coverage Rule – will go into effect later this year.
Sorry hospitals but price transparency is here to stay – like it or not.
SURPRISE! No Surprises Act in Effect
Passed in late 2020, the No Surprises Act went into effect on Saturday, January 1st. This law provides new federal consumer protections against “surprise medical bills.” It supplements – not supplants – any surprise billing laws that have been enacted at the state-level.
“What’s a surprise medical bill?” you ask.
It’s a bill you receive from a healthcare provider or facility who doesn’t participate in your insurance carrier’s network. Sadly, this is common in emergency care. But many people don’t realize that surprise medical bills can occur for non-emergency care too. For example, you may go into an in-network hospital for care BUT receive a service from an out-of-network provider (e.g., anesthesiologist and radiologist) employed or contracted by that hospital.
The No Surprises Act is another great moment for “healthcare consumerism” but PLEASE proceed with caution particularly when it comes to receiving and signing consent forms from providers. A surprise medical bill is an attempt by a provider to collect from YOU – the CONSUMER – the difference between a) what he/she charged for a service you received under their care and b) the amount he/she was paid by the insurance carrier for that service. This practice is known as “balance billing.” The No Surprises Act is supposed to protect you from waiving certain balance billing rights. As a CONSUMER – not a PATIENT – it’s your responsibility to read and understand the forms you’re asked to sign or risk waiving those rights.
Don’t back down.
When a provider asks you to sign an agreement, one patient advocate suggests you write a note on it stating that you will not pay if said provider balance bills you. Then initial it to make your intention clear.
Go one step further: take a photo of the form (with your note on it) as “evidence.” Under the No Surprises Act, consumers can dispute surprise bills through an appeal process.
Here are some great resources from CMS explaining the law and your rights in more detail:
Other and similar practical ways you can protect yourself from getting taken advantage of by the U.S. healthcare system can be found in the pages of “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win” which came out last year.
Written by investigative journalist and Pulitzer Prize finalist Marshall Allen, it was the last book I read in 2021. I wrote a review on it (hint: I LOVED it!)
Speaking of the book…
Belated Christmas Gift!
Got a nice gift in the mail to start off 2022!
Marshall’s mission to empower YOU is inspiring. I’m honored and humbled to play a (small) role in it.
medASTUTE will continue to do the same through this blog and other methods that we can’t wait to reveal in the coming weeks and months.
In the meantime, I encourage you to get the book – if not for you but someone close to you.
Did you know you can set an emergency care payment limit?
I sure didn’t!
For less than many medical / pharmacy copays, you can apply this and other lessons from the book – like so many other Americans have – to save yourself hundreds (possibly even thousands) of dollars in healthcare costs.
Marshall’s package was delivered on Monday (January 3rd), just in time before I fly.
Which leads me to a final – and personal – update…
Movers & Shakas
This morning, I completed drafting this post (although I started on it Thursday morning) while trying to get a whole bunch of stuff completed this week before my first trip of the new year.
Back to my home state of HAWAI’I!
Not for vacation – although I will sneak in a little bit of relaxation here and there – but more so to see family and to participate in a great cause.
I’m beyond thrilled and humbled by this selection.
One of 2021’s best highlights for me.
Participating in the program will most certainly be 2022’s best highlights for me.
But I haven’t even started packing and I fly tomorrow (Saturday).