Billing Arbitration Comes To An End After Changes To No Surprises Act
Last week, a court ruling saw parts of the surprise billing law vacated, and this has now resulted in the federal government stopping processing payment disputes between providers and insurers over out-of-network bills, Modern Healthcare reports. Axios notes insurers sometimes pay double for the same procedure versus Medicare Advantage prices.
Modern Healthcare:
No Surprises Act Ruling Halts Billing Arbitration Process
The federal government stopped processing payment disputes between providers and insurers regarding out-of-network bills following last week's court ruling that vacated parts of the surprise billing law. The Centers for Medicare and Medicaid Services and Health and Human Services Department paused the independent dispute resolution process Thursday as the agencies adapt to a court ruling earlier Thursday that invalidated the federal government’s fee increases for filing disputes and batching requirements that would bundle multiple claims in a single dispute. (Kacik, 8/7)
Axios:
Why Insurers Are Paying Double For The Same Procedure In The Same Hospital
Hospitals charge commercial health plans two to three times more than what they charge the same insurer's Medicare Advantage plans for the same procedure, a new study in Health Affairs found. While it's well established that private plans are typically charged more than Medicare, this study leverages the latest available pricing data to shed light on differing dynamics between the commercial and Medicare Advantage markets. (Dreher, 8/7)
In other health industry developments —
The Washington Post:
Latinos Underrepresented Among Physicians, Overrepresented As Aides
Latinos — especially Mexican Americans — remain underrepresented in the U.S. medical workforce, according to a recent analysis. The study, published in the journal Health Affairs, found that Latino and Hispanic groups are underrepresented in medical professions that require advanced degrees and overrepresented in similar professions that don’t require a bachelor’s or higher degree. (Blakemore, 8/6)
Axios:
Northwest Arkansas Children's Hospital Gets $25 Million Donation
Northwest Arkansas' children's hospital has received its largest donation ever — $25 million toward the expansion plans it announced earlier this year. The expansion is poised to keep NWA's growing population of children closer to home for health care and create a regional hub for children's health care. Plans entail new construction, expanded services in a number of specialties and more doctors. (Golden, 8/7)
Modern Healthcare:
Babylon, MindMaze Deal Won't Move Forward
Babylon Health said Monday its proposed deal to go private with MindMaze, a digital health company focused on brain health, will not move forward. Babylon, an artificial intelligence-enabled virtual diagnosis and medical appointments company, announced the would-be deal to go private and combine with MindMaze in June. The deal was proposed by London-based investment manager AlbaCore Capital Group, which secured a term loan facility for Babylon in November 2021. (Perna, 8/7)
Stat:
Hospitals Use Virtual Reality To Design More Inclusive Rooms For Kids
For many young patients, harsh lights, bare walls, and windows facing parking lots or brick buildings make already painful hospital visits more unpleasant, stoking fear and uncertainty instead of hope. Often, those patients say, it makes recovery harder. Their perspectives — historically overlooked in hospital design — are at the heart of a budding movement to make architecture more inclusive for the people who actually spend time there. (Ravindranath, 8/8)
KFF Health News:
What One Lending Company’s Hospital Contracts Reveal About Financing Patient Debt
With tens of millions of Americans burdened by medical debt, hospitals and other medical providers are increasingly shuttling their patients into loans serviced by banks, credit cards, and other financial services companies. The arrangements have proven very profitable for lenders. But, as KFF Health News reported in November, the rise of the patient financing industry is often less welcome for patients, who can end up in loans that pile interest on top of what they owe for their medical care. (Levey, 8/8)
Also —
The New York Times:
Queens Doctor Charged With Drugging And Assaulting Patients On Camera
Zhi Alan Cheng, a former doctor at a prominent New York hospital, recorded dozens of videos as he raped and sexually abused women, prosecutors said. (Closson and Schweber, 8/7)
AP:
A Florida Man Is Charged With Flooding An Emergency Room After Attacking A Nurse And Stripping
A man in southwest Florida has been charged with flooding a hospital’s emergency rooms after attacking a nurse and stripping off his clothes, authorities said. The 53-year-old became agitated while in a waiting room at the North Collier Hospital in Naples, Florida, on Saturday, according to a report from the Collier County Sheriff’s Office. He barged into the emergency room, pushed a patient and then pushed a nurse in the head. After the hospital staff got him into a room in an effort to keep him from disturbing other patients, he took off his clothes and pulled a high-pressure water pipe from the wall, the report said. (8/7)
