How the seemingly largest hospital bill came to be

September 20, 2011 J Roberts

Read about the world’s largest healthcare bill.

By Karen M. Cheung

It may be the largest hospital bill ever. Estimated at $9.2 million, including interest, the bill is from Tampa (Fla.) General Hospital for the care of deceased Tameka Jaqway Campwell.

Although the American Hospital Association, the Health Care Financial Management Association, and even the Guinness Book of Records couldn’t confirm the highest hospital bill in history, according to Associated Press (AP), the $9.2 million in charges for one patient certainly draws questions into high healthcare costs and end-of-life decision making.

Campwell had an incurable disease, progressive demyelinating neuropathy. The patient’s mother Holly Bennett accused the hospital of not feeding her daughter and giving her too much morphine, which, she claimed, resulted in the patient’s weight falling to 37 pounds, reports the AP. Campwell died two years ago.

The hospital is suing the patient’s estate for the outstanding bill.

“If they think they’re getting money from me, they’re crazy,” Bennett said in the article. “Who’s ever even heard of a bill that high?”

Although the hospital charges will likely drop to $2.25 million after readjustments, Bennett told ABC News she would not pay the multimillion-dollar bill. She said that she never received an itemized bill during the five years of treatment and that the lawsuit is a strategy to prevent her from filing her own lawsuit for medical malpractice against the hospital.

A frequent complaint from patients and providers alike, patients often do not understand the associated costs for tests and care with no clear prices for services.

“This is tragic,” said Alan Sager, a professor of health policy and management at Boston University School of Public Health, in the ABC article. “A patient apparently received costly care that might have made her more comfortable–and might have slowed the progression of her illness, but these interventions apparently could do little more than slow a steep decline.”

Hospital palliative care has doubled in the past decade, ranking as one of the fastest growing specialties with 63 percent of U.S. hospitals using palliative programs. According to a Center to Advance Palliative Care report this month, there are 1,568 palliative teams at nationwide hospitals, up from just 658 in 2000.

NJ hospital bills highest in nation

December 15, 2009December 22, 2009 J Roberts

New Jersey leads the country with the highest charges for health care services. According to the below article, charges by hospitals in New Jersey are four times higher than the actual cost. This a serious matter and New Jersey hospitals are not alone in the practice of pricing procedures based on inflated charges that they assert are a reflection of the market. Read the examples in the article and take warning; if you use a non-participating hospital, or are uninsured or have hospital out-of-pocket expenses – never pay the full charge! Medical Cost Advocate may be able to assist you by negotiating your claim and reducing your bill.

Star-Ledger – Trenton Bureau

The pain in Dan Abrams’ leg throbbed so much he could barely stand.

Still, the 60-year-old Somerville resident, who friends say had just canceled his health insurance because of the tough economy, debated from a hospital emergency room whether he should stay and run up thousands of dollars in debt, or take antibiotics from home and hope they arrested the mysterious infection in his leg.

Fearing he could lose his home and flooring business, Abrams chose to leave Somerset Medical Center after a hospital physician said staying would “run him a lot of money,” said Connie Dodd, a close friend who drove him to the hospital and heard the conversation. “I begged him to stay. But Dan’s a proud man. Talk of all the bills got him scared.”

When Connie and her partner, Cindy Weiss, brought Abrams dinner the next night, July 29, they found his lifeless body in bed. Weiss performed CPR but it was too late. “It was a nightmare,” Dodd said.

For people without health insurance, few things are more intimidating than the arrival of a hospital bill.

Nowhere is the sticker shock worse in the country than in New Jersey, according to health experts and a new report by the New Jersey Health Care Quality Institute, a prominent health care policy group based in Trenton.

New Jersey’s hospital “charges” the price list used to negotiate the cost of a bill for the uninsured and for insured people who use a hospital outside their network are four times higher than the actual cost of treating a patient.

For thousands, the charges mean astronomical bills after a hospital stay. Insurers contend they also force higher premiums for anyone with health insurance.

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Insurers point finger at fees

August 24, 2009August 24, 2009 J Roberts

Sarasota Herald-Tribune – Online

Attend any town hall meetings over healthcare lately? It should be no surprise that a hot topic of discussion is the outrageous and exorbitant medical charges by doctors and hospitals to patients. Make no mistake, doctors, hospitals and other healthcare professionals can charge any amount without any sound economic basis or rationale. On the flip side, while charges often border the absurd in terms of excessiveness, most healhcare providers are willing to negotiate. Medical Cost Advocate can assist in reducing those charges and bringing them down to a fair and equitable level to save you money.

Maria Davis poses last month with sons Ryan and Jack, left, at home in Miller Place, N.Y. Ryan fell and received three stitches; she got a $6,000 bill. Insurers say a survey shows how medical fees are a significant part of the nation’s health care problem.NEW YORK TIMES / MAXINE HICKS

A patient in Illinois was charged $12,712 for cataract surgery. Medicare pays $675 for the same procedure. In California, a patient was charged $20,120 for a knee operation for which Medicare pays $584. And a New Jersey patient was charged $72,000 for a spinal fusion procedure that Medicare covers for $1,629.

The charges were cited in a survey sponsored by America’s Health Insurance Plans in which insurers were asked for some of the highest bills submitted to them in 2008. The group, which represents 1,300 health insurance companies, said it had no data on the frequency of such high fees, saying that to its knowledge no one had studied that question. But it said it did the survey in part to defend itself against efforts by the administration to portray certain industry practices as a major part of the nation’s health care problems.

The health insurers, saying they felt unfairly vilified, gave the report to The New York Times before posting it online today, explaining that they wanted to show that doctors’ fees are part of the health care problem.

The group said it had used Medicare payments for comparison because Medicare was so familiar and payments are, on average, about 80 percent of what private insurers pay.

“It’s the Wild, Wild West when it comes to prices of anything in the U.S. health care system, whether for a doctor visit or for hospital charges,” said Jonathan S. Skinner, a health economist at Dartmouth.

The situation is so irrational, said Uwe E. Reinhardt, an economist at Princeton, that it simply cannot go on.

“We will not emerge out of this decade with this lunacy,” Reinhardt said, adding, “You worry about credit card charges, you scream for consumer protection — why not scream for it here?”

But Dr. Robert M. Wah, a spokesman for the American Medical Association, says there is another side to the story — insurers’ low payments to doctors who enter into contracts with them and the doctors’ difficulties, in many cases, in getting paid at all. That is why, he said, doctors may simply abandon insurance plans. Then patients end up with extra fees because they have to go outside their networks.

Karen Ignagni, president and chief executive of America’s Health Insurance Plans, had a different view, saying “As we think about the health care debate, what’s been talked about is, What are the cost-sharing levels? What are the premium levels? How much do health plans pay? No politician has asked how much is being charged.”

Some of the legislation being considered by Congress would require insurers to increase their disclosure to patients of possible out-of-network costs. And President Barack Obama has proposed changing how Medicare sets its payments to doctors and hospitals. But there are no specific proposals to control prices for out-of-network medical services.

In the survey, patients were insured but saw doctors out of their networks of care providers. When patients go outside their networks, doctors have no obligation to accept the out-of-network fee from insurers as payment in full. Patients may then be accountable for the balance.

The survey looked at 10 companies that insure patients; the companies provided some of the highest bills from 2008.

State laws protecting patients from getting stuck with medical bills in excess of their normal deductibles or co-payments to providers in their insurance networks, vary widely, said Betsy M. Pelovitz, the group’s vice president for state policy. And, she said, the laws often offer little or no protection to patients who seek care outside their insurance networks.

No one intervened for Maria Davis when her son fell and hit his mouth on a floor. Davis, a respiratory therapist on Long Island, took 4-year-old Ryan to an emergency room. “He was bleeding a lot,” Davis said.

She said a doctor said he would put in a couple of stitches but seemed uncomfortable treating the agitated child. When he said he could call a plastic surgeon, Davis agreed. The surgeon, Dr. Gregory J. Diehl of Port Jefferson, “was very nice,” Davis said. He put in three stitches, and Davis assumed his bill would be fully covered by her insurer, United Healthcare. It was not. The bill was $6,000. The Davises paid their deductible of $350. After United Healthcare paid $2,024.80, Diehl reduced his bill by $2,100 and billed the Davises for the balance, $1,525.20.

He did not return calls to his office.

So far, the Davises have not paid the balance.

“I told them I thought it was an unreasonable amount,” said Jonathan Davis, Ryan’s father.

“We have gotten several letters, and they have gotten more than a little threatening,” Davis said.