Coronavirus

An intubated coronavirus patient was declining rapidly when doctors decided to airlift her to a hospital with better critical care resources.

“It’s life or death,” the family of the 60-year-old woman recalled being told when it happened in April. “We have to transfer her now.”

The patient was flown by helicopter from one Philadelphia hospital to another 20 miles away. She spent six weeks at the new hospital and survived. When she came home, a letter arrived: The air ambulance company said she owed $52,112 for the trip.

Last year, Congress abandoned its attempt to prevent surprise bills like this one, and coronavirus patients are now paying the price. Bills submitted to The New York Times show that patients often face surprise charges from out-of-network doctors, ambulances and medical laboratories they did not pick or even realize were involved in their care.

The plan to ban these kinds of bills was popular and bipartisan, and it was backed by the White House. It fell apart at the 11th hour after private-equity firms, which own many of the medical providers that deliver surprise bills, poured millions into advertisements opposing the plan. Committee chairs squabbled over jurisdictional issues and postponed the issue. Then the pandemic struck.

The Pennsylvania patient had no way of knowing that her helicopter, which transported her between two in-network hospitals, did not have a contract with her health insurance plan. Nor could she have known that the air ambulance service, owned by a private-equity firm, faces multiple lawsuits over its billing tactics.

Her health plan, Independence Blue Cross, initially said it would pay $7,539 of the bill, according to billing documents reviewed by The Times, but then rescinded the money. The patient, housebound because of lingering coronavirus symptoms, was left with the full amount.

“She was intubated and on a ventilator when her providers felt it was necessary that she be transferred,” said Leslie Pierce, a division chief at the Pennsylvania Insurance Department, who handled the complaint that the patient submitted to the agency. “She had no decision in the selection process.”
[...]
Surprise medical bills happen when patients receive care from an out-of-network provider they did not choose. These charges are common in certain corners of the health system like the emergency room, where 20 percent of patients are vulnerable to surprise medical bills.

The bills are especially pervasive after ambulance trips: One recent study found that as many as 71 percent of those rides could result in surprise, out-of-network bills.
[...]
Many health insurers have promised to cover plan members’ coronavirus hospital stays in full, another effort to hold patients harmless.

But these protections leave significant gaps, as patients are beginning to find. While many hospitals and doctors received provider relief funds, a number of medical laboratories and ambulance services did not. That leaves those providers free to bill however they’d like.

Insurers’ policies that cover coronavirus hospital stays, meanwhile, sometimes do not include the ambulance ride it took to get there — or follow-up care to treat long-term symptoms.
[...]
Air ambulance bills are often the most costly type of surprise medical bills. Dr. Chhabra found a median charge of more than $38,000, leaving the typical patient responsible for more than $21,000 after the insurance payout. The prices are quickly increasing, too, rising about 15 percent each year since 2015.
[...]
Ground ambulances, another source of surprise bills for coronavirus patients, have also largely escaped billing regulations. California passed legislation in 2017 that barred most types of surprise medical bills, but it excluded ambulances. The congressional deal that nearly passed also did not include ambulances. Legislators may be reluctant to regulate ambulances because many are run by local and municipal governments, which rely on the charges for revenue.
[...]
Air Methods said the document received by the Pennsylvania patient, which stated the “amount due” above a box to write in a credit-card number, was not a bill but rather “an update on where things stood” with her insurance company. The company estimates it has transported 3,300 coronavirus patients over the course of the pandemic, and said that it had a “special process” for handling their billing. ...

The Pennsylvania patient ultimately filed a complaint with the state’s insurance commissioner, Jessica Altman. While Ms. Altman’s office has no authority to regulate air ambulance bills, her staff did make a phone call to the insurer. The situation then resolved quickly. Independence Blue Cross said in a statement that it had already begun reprocessing the claim by the time the regulator called.

The health insurer initially sent the patient documents stating, “You are responsible to pay the amount the provider may bill you.”

Shortly after the regulator’s inquiry, the patient learned the health plan would cover the bill completely.

It’s excruciatingly hard to chirp "Get well soon!" to this particular patient.

But since Trump pointed out last week, the virus "affects virtually nobody, and has currently only affected 200,000 American nobodies to death ... it really would be an irony, Wilso.

Was you an understudy to Baghdad Bob?

Does it bother you that the President of the United States, with all the resources of the government at his disposal made a statement about the top health risk impacting the country, a disease that has killed hundreds of thousands of Americans in eight months and you're not sure whether or not it's true?

I'm saying the President of the United States had a critical statement about an important issue to the country and by your own statement, you aren't sure if it is true. If Dr. Fauci made a statement about COVID19, I would confidently trust it to represent the facts as best understood by the scientific community. The President has many more resources and a much greater responsibility to communicate it to the public yet you're not sure whether or not it's true. Does it concern you that you're not sure that when the President speaks on such a critical issue that you doubt it?

You said, looking at the his own words without distortion from anyone else, that you aren't sure what the President said is true. I don't blame you, I don't trust the President to tell us true information either. I trusted Bush to tell it straight. Even when he said Iraq had WMD, I didn't think we needed to invade, but I believed he was accurately relaying what the intelligence community believed. When Obama spoke, I believed him. I'm not talking about the occasional gaffe by either man, I saying when they said what they meant to the nation, I trusted them to say the truth. Does it bother you that you're just not sure if the President of the United States is telling it straight? It does me.

Even your own post called that a gaffe, but it really doesn't matter. Does it bother you that you can't trust that what the President says is true?

Because you can't trust the President, you had to look it up (and Covid19 does affect the young, sometimes very seriously, but not often fatally if it matters to you). Your own words, the President spoke, no gaffe, just repeated a line he used repeatedly and you weren't sure if it was true. Why doesn't that bother you? You keep talking about other people misspeaking to avoid answering the question. Why do they matter at all? Shouldn't you be able to assume the guy you voted for will speak truthfully?

Biden isn’t the president, he doesn’t have presidential access to all the data, Trump does, and you still don’t trust what Trump says.

Btw, I never believed Dubya when he said Saddam had WMDs. I wanted Hans Blix to be given more time.