surprise medical bills

After her pregnancy, Danielle Laskey discovered the hospital was out of network for her health plan, and her insurer said surprise-billing laws protecting patients from big out-of-network bills for emergency care did not apply

A surprise-billing law loophole? Her pregnancy led to a six-figure hospital bill

1:33pm February 28, 2023

by Harris Meyer

Billing experts and lawmakers are playing catch-up as providers get around new consumer protections, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.

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Paul Davis is a retired physician in Findlay, Ohio, who gets weekly treatments of the drug Kimmtrak to help stave off the progression of his rare cancer — uveal melanoma. He worries the accumulating cost of the drug — nearly $50,000/week if he has to pay it out of pocket — could saddle his family with crushing medical debt after he's gone.

Nearly $50,000 a week for a cancer drug? A man worries about bankrupting his family

5:00am February 14, 2023

by Fred Schulte

Medicare suddenly stopped paying for the pricey drug that prolongs his life. As he waits for an appeal, this retired physician wonders if he should give up treatment to spare his family the cost.

Sugar and Greg Bull play with their twins, Redford and Scarlett, who were born prematurely in 2020. Their insurance company initially said the births were not an emergency, and the family ended up with bills totaling more than $80,000.

Health & Safety

An $80,000 surprise bill points to a loophole in a new law to protect patients

7:25am February 23, 2022

by Jay Hancock

An insurer refused to pay bills related to the premature birth of the Bull family's twins because it said their delivery wasn't an emergency and their stays in the NICU weren't medically necessary.

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Jason Dean received six stitches and a tetanus shot after he cut his knee in May. In August, his wife, DeeAnn, feared going to the same emergency room where he was treated, delaying her diagnosis of Rocky Mountain spotted fever.

Health & Safety

The ER charged him $6,589.77 for 6 stitches, a cost that led his wife to avoid the ER

4:26pm November 30, 2021

by Blake Farmer

With few options for health care in their rural community, a Tennessee couple's experience with one outrageous bill could have led to a deadly delay when they needed help the most.

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HHS Secretary Xavier Becerra says doctors who are balking at the rules of the No Surprises Act aren't looking out for patients. "I don't think when someone is overcharging that it's going to hurt the overcharger to now have to [accept] a fair price," Bece

Doctors are mad about surprise billing rules. Becerra says stop gouging patients

2:57pm November 22, 2021

by Michael McAuliff

Health and Human Services Secretary Xavier Becerra says health providers who have exploited a complicated system to charge exorbitant rates will have to bear their share of the cost — or close.

Some doctors, medical associations and members of Congress are complaining that the rule released by the Biden administration this fall for implementing the law to stop surprise medical bills actually favors insurers and doesn't follow the spirit of the l

Biden's plan to stop surprise medical bills faces bipartisan pushback in Congress

1:20pm November 17, 2021

by Michael McAuliff

Congress passed a law last year to shield patients from surprise out-of-network medical charges. But many doctors in the House now say the way the law is to be implemented unfairly favors insurers.

The No Surprises Act is intended to stop surprise medical bills. It could also slow the growth of health insurance premiums.

Health & Safety

Coming soon, a surprise billing law may have unintended effects on health care

10:51am October 14, 2021

by Julie Appleby

The new law means patients can't get hit with pricey, unexpected medical bills. Some experts say the regulation could also slow the growth of health insurance premiums.

Truck driver José Mendoza has a Humana HMO plan through his employer. It has a $5,000 deductible and 50% coinsurance, leaving him financially vulnerable.

Health & Safety

A $10,322 Tab For A Sleep Apnea Study Is Enough To Wreck One Patient's Rest

4:21pm May 27, 2021

by Michelle Andrews

The University of Miami Health System charged truck driver José Mendoza six times what Medicare would pay for an overnight test. He got trapped by his high-deductible health plan and sky-high billing.

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A car accident in 2019 smashed six of Mark Gottlieb's teeth and severely damaged four vertebrae. The spinal surgery he needed as a result led to medical bills that exhausted the personal injury coverage in his auto insurance.

Surprise: The Charge For His Spine Surgery After A Car Crash Topped $700,000

10:14am April 22, 2021

by Julie Appleby

Generous personal injury coverage on your auto insurance policy may not be enough to cover your medical bills. Patients can get financially blindsided when car and health insurance policies differ.

For one Ohio Medicare patient, the same pain-relieving steroid shot that used to cost her about $30 went up to more than $300 just because her doctor started giving it in a hospital-affiliated clinic instead of her former office.

Her Doctor's Office Moved 1 Floor Up. Why Did Her Treatment Cost 10 Times More?

4:43pm March 26, 2021

by Lauren Weber

Same building. Same procedure. Same doctor. But there was an extra "facility fee" because the location changed slightly. A shot that used to cost her about $30 went up to more than $300.