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Morning Briefing

Summaries of health policy coverage from major news organizations

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Friday, May 20 2022

Full Issue

Court: Patient Doesn't Have To Pay Gigantic Surprise Bill

The Colorado Supreme Court ruling said internal hospital chargemaster rates “have become increasingly arbitrary and, over time, have lost any direct connection to hospitals’ actual costs, reflecting, instead, inflated rates set to produce a targeted amount of profit for the hospitals."

Newsweek: Woman Charged $303,709 For $1,337 Surgery Wins Court Battle Against Bill

A woman who was billed $303,709 for surgery that she was expecting to pay $1,337 for back in 2014 has taken a significant step towards having that debt wiped after the Colorado Supreme Court ruled in her favor. According to the Denver Post, St. Anthony North Health Campus hospital had represented to French that a pair of back surgeries she needed would cost her $1,337 out of pocket, with her health insurer picking up the remainder of the bill. (Beresford, 5/19)

The Washington Post: Lisa French, Billed More Than $300,000 By Colorado Hospital For Back Surgery, Wins State Supreme Court Case

As part of the forms she filled out at the nonprofit hospital in Westminster, Colo., operated by Centura Health, [Lisa] French unknowingly had signed up to pay all charges related to the hospital’s then-secretive “chargemaster” price rates — a master list of prices that determined the sticker prices for everything the hospital did. Years after French argued she was never informed of the chargemaster and engaged in a years-long legal battle with the hospital, the Colorado Supreme Court ruled in her favor this week, saying she is not liable to pay the rest of the massive bill because she did not agree to the hospital’s secret pricing schema. (Bella, 5/19)

AP: Court Tosses $300,000 Hospital Bill For Promised $1,300 Tab

Justice Richard Gabriel, writing for the court, further asserted that internal hospital chargemaster rates “have become increasingly arbitrary and, over time, have lost any direct connection to hospitals’ actual costs, reflecting, instead, inflated rates set to produce a targeted amount of profit for the hospitals after factoring in discounts negotiated with private and governmental insurers.” The drawn-out case first went to a civil trial, which found French owed Centura Health only an extra $767. An appeals court later ruled for Centura, finding that hospitals can’t predict exact care costs in advance and that the term “all the charges” included in the contract obligated French to pay to full amount charged her. (5/19)

Also —

Colorado Sun: Colorado Hospitals Near Top For Prices For Privately Insured: Study

Colorado hospitals in 2020 on average charged privately insured patients nearly three times what Medicare paid for the same services, according to a new report released this week. The report, from researchers at Rand Corp., a nonpartisan think tank, ranked Colorado 12th in the nation for the gap between Medicare and the privately insured. Nationwide, hospitals charged privately insured patients an average of 224% of what Medicare pays for the same services. (Ingold, 5/19)

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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