Media, Legislatures Take Aim at Healthcare Providers

Healthcare providers and their member organizations in the last year have taken more steps to reform patient billing than in the previous two decades combined, but that has not stopped the media nor lawmakers from continuing to pile on.

Television is currently in what are called “sweeps,” where local news pulls out all stops to attract viewers. Expect to see plenty of stories about some hapless individual who unexpectedly receives a giant medical bill. For example, KPNX, the NBC affiliate that is co-owned by the Arizona Republic newspaper, completed a seven-part news special report covering the more alarmist aspects of healthcare bills and their impact on consumers.

Even when reporting is relatively balanced, such as this recent article by Kaiser Health News and National Public Radio, the subtext still attacks providers. The headline–”With Medical Debts Rising, Doctors Are More Aggressive About Payments”–does the story as disservice, as there is nothing aggressive about what healthcare providers are doing. A better headline might have been, “Doctors Step Up Efforts to Get Patients to Pay Bills.”

On the Legislative Front

Across the country state legislatures are looking to add more regulation and control over how healthcare providers manage their respective businesses. Among some of the legislation either passed or under consideration:

• New York state passed a bill that requires healthcare providers to give patients advance notice for out-of-network services beginning April 1, 2015. The insurance plans sold through the state’s exchange prohibit beneficiaries from using out-of-network physicians and hospitals.
• California’s legislature is mulling a bill that requires not-for-profit hospitals to maintain a minimum charity care level of five percent or lose their nonprofit status.
• Connecticut’s legislature is considering a bill that would prevent not-for-profit hospitals turning for-profit. The state is also pursuing laws to increase transparency into healthcare provider billing, specifically into facility fees charged by hospital-owned physicians practices.
• Pennsylvania’s House of Representatives has passed a bill requiring hospitals to inform patients when they are held for observation status versus being admitted.