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Thursday, May 14 2015

Full Issue

A $38,000 Outpatient Surgical Bill Justified By Regional Hospital Price Variations

A former health-insurance worker was surprised and concerned that her Havasu, Ariz., hospital charged so much for an hour-long eye-lid procedure. But her health insurer agreed to pay nearly $30,000, saying the charges were "allowable." Elsewhere, the Montana Supreme Court revived a case accusing hospitals of unfairly charging different rates for insured and uninsured patients.

Teresa Anderson was pleasantly surprised how quick and hassle-free her eyelid-lift surgery was at Havasu Regional Medical Center's outpatient-surgery facility in April 2014. ... Weeks later, the bills arrived at her Lake Havasu City home. Her surgeon, anesthesiologist and X-ray provider submitted bills and were paid nearly $2,250. Only one remained: Havasu Regional's bill. When it finally arrived last May, what she saw shocked her. An explanation of benefits from her insurer, Blue Cross Blue Shield of Minnesota, showed she and Blue Cross had been billed $38,526 by Havasu Regional for prep work, surgery and recovery lasting less than three hours. (Alltucker, 5/13)

The Montana Supreme Court has revived the case of a woman who says it's unfair for hospitals to charge different rates to treat insured and uninsured patients. The high court reversed District Judge James Reynolds' decision last year to throw out the case challenging the agreements hospitals make with insurance companies to set discounts for the companies' customers. (Volz, 5/13)

In other hospital industry news -

Four Tenet Healthcare Corp. hospitals are the target of a federal criminal probe into allegations executives paid kickbacks to obstetric clinics for patient referrals, the company said in securities filings. The investigation arose from a 2009 whistle-blower lawsuit accusing Tenet鈥檚 hospitals of paying local clinics to send pregnant, undocumented Hispanic women to their facilities for deliveries covered by Medicaid, officials of the Dallas-based hospital chain said in a May 4 filing. (Feeley, 5/13)

Hospitals in the Twin Cities saw net income increase for a second consecutive year in 2013, according to a report released Wednesday, even as the number of patient days in the hospital continued to decline. Collectively, 30 Twin Cities area hospitals reported net income of $641.1 million in 2013, up from $533.7 million in 2012, according to an annual report on hospital finances from Allan Baumgarten, an independent hospital analyst in St. Louis Park. (Snowbeck, 5/13)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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