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They need outsized returns to service the debt and pay it down - returns they cannot get via in-network rates. Private equity-backed physician staffing firms, in particular, have large incentives to continue surprise medical bills unabated because their business model - of buying out companies and loading them with excessive debt - depends on it. A recent academic study, for example, found that if these medical specialists were not able to charge out-of-network rates, physician payments from privately insured patients would have been 13.4 percent lower and annual spending for people with employer-sponsored insurance would have been $40 billion lower. With the length of stays unpredictable but likely to be long, patients may face particularly large surprise bills compared to the past.Įven in non-crisis times, patients have faced millions of dollars in out-of-network bills. Once admitted, patients may continue to face surprise medical bills by out-of-network doctors. They stand to make “outsized” returns as the surge of COVID-19 patients overtake ER rooms and are admitted to hospitals. Legislation to curb surprise medical bills has failed to pass the House or Senate after almost a year of haggling over technical provisions: While patient advocates and payers want out-of-network doctors to charge a fee benchmarked to in-network or local rates, physician providers and staffing companies backed by private equity firms have lobbied hard to prevent this, resulting in a stalemate.Īt this time of crisis, large physician staffing firms that have been the worst offenders of surprise medical billing may take advantage of the crisis. The physician staffing firm can charge whatever it likes. If patients go to the emergency room of a hospital covered by their health insurance, they may receive a large out-of-network bill if the ER has been outsourced to a physician staffing firm that is not covered by the insurance. It also doesn’t take up the issue of surprise medical billing at a time when we expect a massive surge in emergency room visits and hospital admissions related to the disease. But it doesn’t cover hospitalization or care needed for people who actually contract the disease.

While imperfect, this bill will do much to provide free COVID-19 testing and extended paid sick leave for many but not all workers.

In the crush of news over the explosive spread of COVID-19, Congress has moved aggressively to pass the Families First Coronavirus Response Act.

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