November 20, 2017

“The Medical Cost Reduction Act of 2017”

Law #1 – Establish A National Fee Schedule for Emergency Procedures
For unscheduled hospital admissions and surgeries, patients cannot realistically “consent” to provider charges.

The documents that patients must  sign to “pay whatever is charged”  or to “ pay whatever your insurance does not cover” are what legal scholars call ‘procedurally unconscionable.’

The patient must agree to the terms of the providers.  The only way to receive desperately-needed care is to accept whatever charges are assessed. The patient is simply assumed to have provided informed consent to any procedure, and to any fee from any provider. This is not normal commercial practice…..instead it is naked force. And it must change, with the following new rules:

In emergencies, the charges to an uninsured or ‘out of-network’ patient must not exceed 150% of the lowest basic charge in the Medicare fee schedule. (i.e., no upcoding)
Hospitals can no longer use their “chargemaster” rates to bill the uninsured.
Doctors called in for emergencies cannot charge 800% of Medicare, as they often do today.
Any provider who tries to bill above the allowed rates, for patients who are clearly unable to provide informed consent, will be considered guilty of consumer fraud. Not only will their bills be uncollectible, they could be charged criminally in the most egregious cases.

Read the entire article

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