Surprise Bills are Everywhere

August 28, 2019

By Catilin Owens - Axios, August 13, 2019

Surprise medical bills have gotten more common and more expensive, according to a new study published in the Journal of the American Medical Association.

These bills can be devastating to patients, even those who have some savings and a steady source of income.

The study used an Optum database to look at patients covered by a large commercial insurer who received either inpatient or emergency care at hospitals covered by their insurance, and got a bill for out-of-network care.

These bills were probably unexpected. Patients often assume that the care they receive at an in-network hospital will all be covered by their insurer.

Most hospitals don't produce out-of-network bills this often. The results are skewed by serial offenders.

Congress has vowed to prohibit surprise medical bills, but its leading approach is under attack from hospital and doctors' groups.

California's law, which mirrored the approach pending in Congress, shifted contract negotiations in insurers' favor, according to a study in the American Journal of Managed Care.

This has led to even more provider consolidation, the study found.