Inflated Emergency Room Charges Just a Way of Doing Business

Macon, GAEmergency room charges are now to the point where publications dedicated to helping Americans save money and maintain fiscal responsibility are including emergency room cost in their recommendations.

For example, the "Saving Centsably" column carried April 11 in the Macon Telegraph advocated patients ask for a detailed accounting of all emergency room charges. "You might be surprised to find you have been billed for items you did not use," writes columnist Rachael J. Mercer. "There are often charges that can be disputed."

Patients not only have the right to carefully examine invoices and emergency room cost following a visit to the hospital, it's fiscally prudent given widespread allegations that hospitals will often overbill patients with the capacity to pay—through health insurance or otherwise—to make up for losses hospitals may incur treating patients without the means, or for services funded by Medicare or Medicaid.

Ironically, on the very day the Macon Telegraph published the "Saving Centsably" column, the Dallas Morning News was reporting that Tenet Healthcare Corp. had agreed to pay the federal government $42.75 million to settle allegations of overbilling for inpatient rehab costs.

It is not the first time Tenet has been under the microscope for alleged hospital overcharging, according to the report. In 2002, the US Justice Department launched an investigation into allegations that Tenet had overbilled the government. Four years later, in 2006, Tenet agreed to pay $900 million to settle such allegations, and signed an agreement promising it would abide by corporate integrity.

As part of the hospital overcharging settlement, Tenet agreed in 2006 to alert the US Justice Department of any further reports of overbilling.

The US Justice Department did not have to wait long. The next year, Tenet alerted the US Department of Health and Human Services to allegations of overbilling at one of its hospitals in Georgia.

The investigation at the time allegedly found overcharging dating back two years, to 2005. Tenet is alleged to have billed Medicare for patients who did not qualify for the care at the root of the alleged questionable billing, at 25 facilities across the US.

Emergency room charges, and allegations over potentially inflated emergency room fees, have prompted many patients to dispute a medical bill. Various reports have suggested hospitals artificially inflate fees such as an er bill or other items relating to emergency room cost, fully expecting those charges to be disputed and eventually reduced at the behest of a health care provider or insurance company.

However, that dispute mechanism does not help well-heeled Americans who fund their own health care—Americans who are at the mercy of potentially inflated emergency room bills in view of their deep pockets. Unless they stand up and ask the hard questions, the US government and Americans with means will wind up paying far more for their health care than they need.

Medicaid and Medicare aside, without public funding of health care, as is the case in countries such as Canada, for-profit hospitals and clinics need to make their money where they can. All too often, inflated er charges are borne on the backs of those with the ability to pay. Little wonder so many patients are asking, "did I get what I paid for?"