By BOB HERTZ

We Need Legal Assaults On The Greediest Providers!

When a patient is hospitalized, or diagnosed with a deadly disease, they often have no choice about the cost of their treatment.

They are legally helpless, and vulnerable to price gouging.

We need more legal protection of patients. In some cases we need price controls.

In the final part of this series, I discuss how we need to empower patients by allowing them to challenge their medical bills in courts.

Assault Phase Four – Binding
Arbitration of Medical Bills

 We must allow patients to challenge their medical bills in expanded
‘Health courts.’

Patients should be able to contest any bill over $250,  especially if they have not given ‘informed
financial consent’ to the provider.

Such ‘consent’ would require that if a procedure can be
scheduled in advance, it can also be quoted in advance. If the patient requests
an estimate, they must be notified in writing at least seven days in advance.
This would allow the patient to request a different provider, or to investigate
other alternatives. If an estimate is requested but never produced, the patient
has no liability. (That will shake up the providers rather quickly.)

 The  Health Courts will be staffed by
ex-physicians and active judges. All court costs will be paid by the
government, and the patient will not always need an attorney. There will be a
free ‘ombudsman’ service (as Medicare already has) to provide guidance to
patients.

A padded bill of $1500 may be financially significant to a patient, but too small for an attorney to take on the patient’s case, and perhaps too insignificant for the state’s attorney general to pursue. 

The courts can rely on the following principles:

If a patient is insured and their care is
in-network, no balance billing is allowed without informed consent.If the care is out-of-network, they can only be
charged a ‘reasonable and fair fee.’ Generally this will be equal

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