The News-Record published a new story this week about a unique case involving excessive hospital bills. The main issue is whether patients should be able to take hospitals to court to demand that they justify their charges. The issue seems to be a matter of basic fairness in forcing hospitals to at least explain how they arrive at the charges that they cite, particularly in cases where the charge seems incredibly high. While not an issues of medical malpractice, it is still relevant to many who have been victimized by the confusing medical billing process.
The case was brought by a man who was shocked to find out that he owed $20,000 for a three day stay at a local hospital. He was further amazed to learn that the facility charged him a staggering 2400% more for medication that he could pay at a nearby pharmacy for the same medication. In their defense the hospital submitted a bill into evidence, but the bill did not have itemized charges. The man leading the challenge is simply asking that the hospital be forced to explain the charges. He explained, “They [the hospital] are telling you the [they] charge $5,000 for a bed in a hospital and don’t have to tell you what the charges consist of.”
The man in this case is gallantly taking on the legal fight on his own. However, he faces stiff legal opposition as deep-pocketed medical interests are fighting to ensure that they can charge whatever they like without ever having to justify their charges. They claim that the prices are overseen by federal regulators who release “standard” rates. However, there is disagreement about whether “standard” rates are the same thing as “reasonable.”
Each Chicago medical malpractice attorney at our firm understands the way that hospitals sometimes offer exorbitant fees to patients for care. What most community members don’t know is that the price that they are charged is often based on a range of factors that are not exactly fair or logical. Hospitals usually negotiate with insurance companies for prices that will be paid for the performance of certain medical procedures. In exchange for offering lower prices, the insurance company agrees to steer their clients toward those hospitals. When public funds are used to pay for care, via Medicare or Medicaid, the reimbursement rates are even lower. Similarly, when a private citizen is paying for care (without any insurance at all), the hospital may negotiate with the individual for discounted rates.
However, as any Illinois medical malpractice lawyer will tell you, sometimes the hospital uses the patient’s potential recovery in a legal matter as a reason to charge particularly high rates. For example, if an individual is hurt in a car accident that is caused by the negligence of another driver, the injured party may file an accident lawsuit to seek compensation for the harm caused by the negligent party. Anticipating the possible award, the hospital may charge much more for the care that they provide than they otherwise might.
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