Medical Billing and Hospital Overcharges - What Happened to the Hippocratic Oath of "first, do no harm"?

Tampa, FLAttorney Ben Stewart is seeing an increase in hospital overcharging, mostly to uninsured people. "Look carefully at your medical bills. If you have been overcharged and have either started a payment schedule or completed payment, you may be entitled to monetary damages," says Stewart.

"Say you have no insurance and the hospital bills you $100 for an aspirin-yes, it's been done," adds Stewart. "If you can't pay, the hospital will send your account to a collection agency and they will start actions against you. People have claimed bankruptcy because of hospital overcharges."

Stewart also notes that hospital chains seem to be the major culprits, charging outrageous "retail prices" to their uninsured patients, whereas insured patients typically are charged rates 50-75 percent less. Overcharging occurs not just from emergency room billing; Stewart has seen grossly inflated charges on hospital stays and prescriptions, lab tests and x-rays. From administrative fees to equipment charges, hospitals and clinics routinely overcharge their uninsured patients for services wherever and however they can. It's like the wild west. Although there aren't laws to keep hospitals and clinics in check, there is legal recourse.

Overcharging for Medical Records

Last year a class action lawsuit was filed against a New York hospital allegedly for gouging patients for copies of their medical records - charging them twice what the law allows. The New York Post reported that it got caught when retiree Vicky Ortiz was charged $2,963 for 1,758 pages, or $1.50 per page plus an administrative fee for her medical records. Of course, attorneys regularly request copies of such records for their clients and in this case Ortiz' lawyer needed the documents for a personal-injury lawsuit she filed against a nursing home. But the hospital refused to lower the price. A number of similar class actions have been filed nationwide against hospitals claiming they collected "illegal and grossly excessive charges" for copies of the patients' medical records, some of which were collected by a third-party vendor.

In 2015 The Atlantic wrote that on average, all U.S. hospitals charged patients (or their insurers) 3.4 times what the federal government thinks these procedures cost. The hospital incurs $100 of Medicare-allowable costs, and the hospital charges $340, explained the authors, adding that the ratio of hospital charges to costs has only increased over time: In 1984, it was just 1.35, but by 2011, it was 3.3. And as Stewart said, it's likely increased even more.

Researchers at Johns Hopkins Bloomberg School of Public Health in 2015 said the 50 hospitals in the U.S. with the highest markup of prices over their actual costs are charging out-of-network patients and the uninsured more than 10 times the costs allowed by Medicare. It's a markup of more than 1,000 percent for the same medical services. Quipped the researchers, "What other industry can you think of that marks up their prices by 1,000 percent and remains in business?"

"There is no justification for these outrageous rates, but no one tells hospitals they can't charge them," said researcher Gerard Anderson. "For the most part, there is no regulation of hospital rates and there are no market forces that force hospitals to lower their rates. They charge these prices simply because they can."

Stewart says that insured hospital patients rarely get charged the "retail rates" because most private health insurers negotiate lower rates for their patients, but uninsured patients are likely to be charged the full rate. "Insurance companies will negotiate with the hospital-so the insured patient is charged less," says Stewart. "And some hospital networks will negotiate with the debt collector for a percentage of your unpaid medical bill." In some hospitals it seems that the Hippocratic Oath has left the building.