- My Forums
- Tiger Rant
- LSU Recruiting
- SEC Rant
- Saints Talk
- Pelicans Talk
- More Sports Board
- Fantasy Sports
- Golf Board
- Soccer Board
- O-T Lounge
- Tech Board
- Home/Garden Board
- Outdoor Board
- Health/Fitness Board
- Movie/TV Board
- Book Board
- Music Board
- Political Talk
- Money Talk
- Fark Board
- Gaming Board
- Travel Board
- Food/Drink Board
- Ticket Exchange
- TD Help Board
Customize My Forums- View All Forums
- Show Left Links
- Topic Sort Options
- Trending Topics
- Recent Topics
- Active Topics
Started By
Message
Federal Judge Upholds Trump’s Hospital Price Transparency Rule
Posted on 6/24/20 at 11:09 am
Posted on 6/24/20 at 11:09 am
quote:
Judge Carl Nichols granted the administration’s motion for summary judgment on Tuesday, meaning it did not go to trial.
In November 2019, the Trump administration announced historic price transparency requirements aiming to increase competition and lower healthcare costs for all Americans.
The hospital industry argued that the rule wouldn’t help patients understand their out-of-pocket costs after the Centers for Medicare and Medicaid Services proposed the rule in 2019.
LINK
9
Posted on 6/24/20 at 11:13 am to Magician2
The $25.00 Tylenol says hello
Posted on 6/24/20 at 11:16 am to Magician2
(no message)
This post was edited on 1/10/21 at 3:04 pm
Posted on 6/24/20 at 11:17 am to Magician2
pricing is only complicated because it was made complicated by the insurance industry, government regulations and providers banding together under multiple groups and partnerships to maximize income.
Everybody wants their money
If you go to the hospital - you pay the hospital, the PA under another group, the specialist as a separate provider, and the anesthesiologist as a part of a separate partnership all to maximize income and milk insurance payments that were inflated by government regulations in the first place.
The clearinghouses in between need to handle this better and call these people out on their crap. It's borderline fraud.
And it's the middle class patients suffering the most.
Everybody wants their money
If you go to the hospital - you pay the hospital, the PA under another group, the specialist as a separate provider, and the anesthesiologist as a part of a separate partnership all to maximize income and milk insurance payments that were inflated by government regulations in the first place.
The clearinghouses in between need to handle this better and call these people out on their crap. It's borderline fraud.
And it's the middle class patients suffering the most.
This post was edited on 6/24/20 at 11:19 am
Posted on 6/24/20 at 11:23 am to Magician2
I recently dropped my insurance. I was tired of paying for services that not only was I not really using, but weren't giving me any discounts when I DID use it.
I recently had to have some x-rays on my back and knees. I was able to go and find my own clinic to provide those services. I found a place that did it for $160. All of it. And to add to it, I was able to get in and out. I was there a total of 45 minutes.
When my wife broke her toe, we had to have an x-ray for that. I had blue cross blue shield thru an employer at the time. They wanted $800 out of pocket plus whatever they were planning on billing us later. Plus, we were there for over 4 hours. They sent us that bill later (the insurance covered the rest). It was over $2000.
How can the medical community justify having to pay $2800 for an x-ray on a TOE while having insurance but only $160 cash for 3 separate shots consisting of a back and 2 knees?
I recently had to have some x-rays on my back and knees. I was able to go and find my own clinic to provide those services. I found a place that did it for $160. All of it. And to add to it, I was able to get in and out. I was there a total of 45 minutes.
When my wife broke her toe, we had to have an x-ray for that. I had blue cross blue shield thru an employer at the time. They wanted $800 out of pocket plus whatever they were planning on billing us later. Plus, we were there for over 4 hours. They sent us that bill later (the insurance covered the rest). It was over $2000.
How can the medical community justify having to pay $2800 for an x-ray on a TOE while having insurance but only $160 cash for 3 separate shots consisting of a back and 2 knees?
Posted on 6/24/20 at 11:24 am to The Baker
quote:
The hospital industry argued that the rule wouldn’t help patients understand their out-of-pocket costs
Wow, they really went there. Hah
Because it won’t. Hospitals list what they charge, not what any of the thousands of different insurance plans reimburse
Posted on 6/24/20 at 11:27 am to dbbuilder79
quote:Your answer is right there.
How can the medical community justify having to pay $2800 for an x-ray on a TOE while having insurance but only $160 cash for 3 separate shots consisting of a back and 2 knees?
Insurance probably never paid the $2800 anyway. That's the "sticker price".
Posted on 6/24/20 at 11:30 am to dbbuilder79
Builder this happens all the time. When you go to the doctor / Dentist. Ask them the cost with Out insurance. Most of the it is cheaper without using your insurance. I had a cat scan a while back. The cost was less not using my insurance.
Posted on 6/24/20 at 11:32 am to OchoDedos
quote:
The $25.00 Tylenol says hello
No it doesn't because all those prices are already out there under the current rules. The big problem this is going to cause is hospitals having to disclose what you get paid from insurance companies. These are negotiated rates just like any other industry in the country does. Should Ford have to disclose to GM how much they pay for certain parts?
This legislation goes against what most conservatives want. It is going to drag us closer to single payer Medicare and reduce quality going forward as all hospitals get dragged down to the lowest price on all procedures. Want to buy a Lexus? Too bad, you're getting a Yugo.
Posted on 6/24/20 at 11:33 am to theunknownknight
quote:
If you go to the hospital - you pay the hospital, the PA under another group, the specialist as a separate provider, and the anesthesiologist as a part of a separate partnership all to maximize income and milk insurance payments that were inflated by government regulations in the first place.
I can understand why someone, to benefit the middle class, might want the government to interfere with various private entities contracting with each other and their customers in an attempt to stifle the profit motives of these organizations. Just saying that much, much, much, much, much less heavy handed, anti-capitalistic regulations have been called Marxist around these parts.
Posted on 6/24/20 at 11:36 am to Tampa Tiger
quote:
When you go to the doctor / Dentist. Ask them the cost with Out insurance. Most of the it is cheaper without using your insurance. I had a cat scan a while back. The cost was less not using my insurance.
90% of healthcare is not single item testing. If your having a hip replacement or heart bypass surgery, do you want to go to the lowest cost provider or the one with the best quality?
Posted on 6/24/20 at 11:39 am to Tampa Tiger
I don't have much of a choice since I dropped coverage. 
. Last year before I cancelled in October, I had paid over $12,000 for an insurance policy I hardly used. (Roughly $275 a week). The only thing that the insurance helped on was the cost of prescriptions. And I found an app that helps with the cost of those.
. Last year before I cancelled in October, I had paid over $12,000 for an insurance policy I hardly used. (Roughly $275 a week). The only thing that the insurance helped on was the cost of prescriptions. And I found an app that helps with the cost of those.
Posted on 6/24/20 at 11:40 am to Auburn80
(no message)
This post was edited on 9/4/20 at 2:03 am
Posted on 6/24/20 at 11:41 am to Auburn80
quote:
want to go to the lowest cost provider or the one with the best quality?
Could be the same provider.
Outcome data is key.
Posted on 6/24/20 at 11:42 am to dbbuilder79
quote:
I don't have much of a choice since I dropped coverage. . Last year before I cancelled in October, I had paid over $12,000 for an insurance policy I hardly used. (Roughly $275 a week). The only thing that the insurance helped on was the cost of prescriptions. And I found an app that helps with the cost of those.
How often do you use your Homeowners Insurance? It's there for protection in case of a catastrophic loss, not because you are using it a lot. I sincerely hope you do not have anything serious happen to you, because you could end up bankrupt from it.
Posted on 6/24/20 at 11:45 am to Auburn80
quote:The problem here is the patients pay part of the bill. The better analogy would be: "Should Ford have to disclose to GM how much they pay for certain parts when they are both paying the invoice."
The big problem this is going to cause is hospitals having to disclose what you get paid from insurance companies. These are negotiated rates just like any other industry in the country does. Should Ford have to disclose to GM how much they pay for certain parts?
Insurance companies have used EOBs to scare people for decades. OMG that was $50,000 surgery, phew... this $5,000 deductible is a great deal... when the insurance company only reimbursed $5,000.
Posted on 6/24/20 at 11:51 am to bigblake
quote:
This is a false equivalency. Your example is a company paying for an intermediate part. This rule is for what the company is charging the end user. To use your example, it’s analogous to you buying a F150 and not knowing the actual price until a month after the transaction.
The patients estimated cost can easily be determined without the patient knowing what the hospital gets reimbursed by the insurance company. It is not false equivalency. All you have to do is ask for your estimated costs. The bigger problem is most patients have no clue what their coverage even is to begin with. I am not talking about the higher educated crowd, but with the other large group we deal with.
Posted on 6/24/20 at 11:53 am to Auburn80
quote:
Auburn80
Which insurance company/medical provider do you work for???
I've already learned the hard way, FYI. People like me who have to go with a basic govt policy DO NOT get the same kind of treatment as someone who has a larger group policy thru a BC/BS.
I have a number of friends and familyin the medical industry. They have pointed me in the right direction for where to go and who to see. I trust their opinions more than a Dr who is pushing people to his golf buddy specialist.
Also, what would a HEALTH insurance policy do to help me financially if I have a career ending injury? I almost had one once (with insurance) and the medical costs helped me lose my house 12 years ago.
Since I've created my own network of Drs and specialist who take cash, my out of pocket costs have been less than 1 month of coverage from a policy.
Posted on 6/24/20 at 11:53 am to Taxing Authority
quote:
Insurance companies have used EOBs to scare people for decades. OMG that was $50,000 surgery, phew... this $5,000 deductible is a great deal... when the insurance company only reimbursed $5,000.
Totally agree with this. This ruling is not forcing the insurance companies to equally disclose information.
Page 1 of 5
Popular
Back to top
Follow TigerDroppings for LSU Football News