Taking Surprise Medical Bills to Court Some legal experts say contract law could provide consumers another avenue to challenge unexpected hospital bills. By Julie Appleby, Kaiser Health News Dec. 18, 2018 Joaquin Lopez had emergency gallbladder surgery after rushing to an emergency room last year. He has been haggling with Baptist Memorial Hospital in Memphis over what he owes ever since. The 37-year-old college professor was hit with a nearly $8,000 bill from the out-of-network hospital — that was after the $11,000 he and his insurer had already paid. Consumers are increasingly vulnerable to such so-called balance bills, [...]
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Whistleblower to share in $65-million settlement from Prime Healthcare in Medicare overbilling case - Los Angeles Times By Paul Sisson Aug 04, 2018 | 1:20 PM A San Diego whistleblower will receive $17.2 million with the settlement of a 7-year-old false claims lawsuit against Prime Health Care regarding overbilling for Medicare services at 14 California hospitals. The U.S. Department of Justice announced Friday that it has reached a $65-million settlement with the Ontario-based healthcare system, resolving allegations that Prime “engaged in a deliberate corporate-driven scheme to increase inpatient admissions of Medicare beneficiaries” and that the company “engaged in up-coding by [...]
Disparity in medical billing - The Washington Post (Credits) By Wilson Andrews, Darla Cameron and Dan Keating, Published: May 8, 2013 For the first time, the government has released prices that hospitals charge for common inpatient procedures. Until now, these charges were competitive secrets in the industry. While the average bill for procedures across the United States varies widely by type of hospital, the Medicare reimbursement amount doesn’t vary much. The numbers reveal a tremendous, unexplained variation in cost of services. A Washington Post analysis of the data shows that, even on the same street, hospitals can vary by upwards [...]