Congressional Probe Asks Hospitals About Billing Policies

pickledpepperRN · Jul 17, 2003

http://story.news.yahoo.com/news?tmpl=story&u=/dowjones/20030716/bs_dowjones/200307161414001289

Wed Jul 16, 2:14 PM ET

By Johanna Bennett, Of DOW JONES NEWSWIRES

NEW YORK (Dow Jones)--Congressional investigators have asked some of the nation's largest hospital chains to provide information about their billing practices as part of an investigation into billing inequities imposed on the uninsured.

In letters dated July 16, House Energy and Commerce Committee Chairman Billy Tauzin, R-La., and Oversight and Investigations Subcommittee Chairman James Greenwood, R-Pa., requested information from 20 hospital chains, including Tenet Healthcare Corp. (NYSE:THC - News) , HCA Inc. (HCA), Triad Hospitals Inc. (NYSE:TRI - News) and Universal Health Services , by July 31.

The probe targets billing practices of certain health care providers under which patients not covered by health insurance are expected to pay substantially higher amounts for medical services than health insurers and government- sponsored health plans.

"These practices raise significant public health and consumer protection issues. The uninsured seem caught in the middle of the sophisticated and complicated forces driving health care financing including government entitlements, managed care, rising costs and shrinking public funds," the letters read.

The committee said hospitals often inflate rates they establish for medical service beyond their actual costs, in part because of steep discounts demanded by health insurers. Though health plans negotiate to pay far less than "retail charges," individual uninsured patients are expected to pay the full "sticker price," the letter read.

The committee fears that some hospitals may generate a disproportionate share of their profits from a relatively small group of patients. Also, hospitals may feel no incentive to work with patients to develop payment plans.