He Got Tested for Coronavirus. Then Came the Flood of Medical Bills. – The New York Times

Some senators had wanted to put a provision in the coronavirus bill to protect patients from surprise out-of-network billing either a broad clause or one specifically related to coronavirus care. Lobbyists for hospitals, physician staffing firms and air ambulances apparently helped ensure it stayed out of the final version. They played what a person familiar with the negotiations, who spoke on condition of anonymity, called the Covid card: How could you possibly ask us to deal with surprise billing when were trying to battle this pandemic?

Even without an E.R. visit, there are perilous billing risks. Not all hospitals and labs are capable of performing the test. And what if my in-network doctor sends my coronavirus test to an out-of-network lab? Before the pandemic, the Kaiser Health News-NPR Bill of the Month Project produced a feature about Alexa Kasdan, a New Yorker with a head cold, whose throat swab was sent to an out-of-network lab that billed more than $28,000 for testing.

Even patients who do not contract the coronavirus are at a higher risk of incurring a surprise medical bill during the current crisis, when an unrelated health emergency could land you in an unfamiliar, out-of-network hospital because your hospital is too full with Covid-19 patients.

The coronavirus bills passed so far and those on the table offer inadequate protection from a system primed to bill patients for all kinds of costs. The Families First Coronavirus Response Act, passed this month, says that the test and its related charges will be covered with no patient charge only to the extent that they are related to administering the test or evaluating whether a patient needs it.

That leaves hospital billers and coders wide berth. Mr. Cencini went to the E.R. to get a test, as he was instructed to do. When he called to protest his $1,622.52 for hospital charges (his insurers discounted rate from over $2,500 in the hospitals billed charges), a patient representative confirmed that the E.R. visit and other services performed would be eligible for cost-sharing (in his case, all of it, since hed not met his deductible).

This weekend he was notified that the physician charge from Emergency Care Services of New York was $1,166. Though covered by his insurance, he owes another $321 for that, bringing his out-of-pocket costs to nearly $2,000.

By the way, his test came back negative.

When he got off the phone with his insurer, his blood was at the boiling point, he told us. My retirement account is tanking and Im expected to pay for this?

The coronavirus aid package provides a stimulus payment of $1,200 per person for most adults. Thanks to the billing proclivities of the American health care system, that will not offset Mr. Cencinis medical bills.

Elisabeth Rosenthal, a former New York Times correspondent, is the editor in chief of Kaiser Health News, the author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back and a contributing Opinion writer. Emmarie Huetteman is a correspondent at Kaiser Health News.

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He Got Tested for Coronavirus. Then Came the Flood of Medical Bills. - The New York Times