Debt Collector Is Faulted for Tough Tactics in Hospitals

[jacko]

http://www.nytimes.com/2012/04/25/business/debt-collector-is-faulted-for-tough-tactics-in-hospitals.html?partner=rss&emc=rss&gwh=1EC7A4B2395796E4F8D730C2AAF8553B

[jacko]

Reader comment..

"I was in Canada a couple of years ago when I broke my ankle. I was taken to a nearly empty emergency room in downtown Toronto and was seen within the hour (This was an experience I had never had before and I chalked it up to the fact that Canadians don't have to use the emergency room for primary care).
When I was bandaged up and wheeled up to the "cashier" I was asked for my health card. I explained to the lady behind the window that I did not have a card because I was an American. I told her that I would be paying upfront and would file a claim with my insurance company back in the States. She looked horrified. She explained that she would have to charge me about $300 dollars! I started to laugh. Just the aspirin in the U.S. would have cost me that much.
I think that the politicians that have mischaracterized the universal health systems in other Western countries as a mess, and ours as the best option, have really done us a disservice. Hopefully, someday we'll wake up."

[df04527]

Not wanting to really get in to this but do you know what the tax rate is in Canada or elsewhere that pays for the healthcare?

[jacko]

Not wanting to really get in to this but do you know what the tax rate is in Canada or elsewhere that pays for the healthcare?

http://www.cra-arc.gc.ca/tx/ndvdls/fq/txrts-eng.html

[malf1204]

Good answer. That is less than I pay.

[GoingDown]

Forewarned is forearmed:

"the hounding of patients violated the Emergency Medical Treatment and Active Labor Act, a federal law requiring hospitals to provide emergency health care regardless of citizenship, legal status or ability to pay."

"by giving its collectors access to health records, Accretive violated the Health Insurance Portability and Accountability Act, known as Hipaa (pronounced HIP-ah). For example, an Accretive collection employee had access to records that showed a patient had bipolar disorder, Parkinson’s disease and a host of other conditions."

If something like this ever happens to you, stand your ground and demand to see a doctor at the emergency room. Tell the debt collector that they are violating federal laws, and that you will hold them personally liable if they delay any medical treatment for you. Tell them you or your relatives will file a lawsuit against them personally, and against the hospital, if their harassment, unethical, and illegal conduct continues. I'll bet once they hear that, they will stop hounding you for money.

Also, unless you have no choice in the matter-- such as when you are unconscious or badly hurt-- do not bring your credit cards, cash, check book, debit cards, etc. with you to the hospital. Leave them at home.

[malf1204]

Wait do you mean to tell me a Debt Collector is Violating the law? Whoever heard of such a thing?

[justbroke]

I would pay more in taxes in Canada. I wouldn't trade my health care plan for the Canadian universal plan. But that's me.

As for collection agencies violating the law... this is not too unlike any criminal. The laws keep honest people honest; not criminals.

[GoingDown]

It wouldn't be a bad idea to print this out and take it with you, or keep a copy of this in your wallet or purse...

What is EMTALA?

EMTALA was enacted by Congress in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 (42 U.S.C. §1395dd). Its original intent and goals are consistent with the mission of ACEP and the public trust held by emergency physicians.

What are the penalties for violating EMTALA?

Both CMS and the OIG have administrative enforcement powers with regard to EMTALA violations. There is a 2-year statute of limitations for civil enforcement of any violation. Penalties may include:

Termination of the hospital or physician's Medicare provider agreement.
Hospital fines up to $50,000 per violation ($25,000 for a hospital with fewer than 100 beds).
Physician fines $50,000 per violation, including on-call physicians.
The hospital may be sued for personal injury in civil court under a "private cause of action"
A receiving facility, having suffered financial loss as a result of another hospital's violation of EMTALA, can bring suit to recover damages.

An adverse patient outcome, an inadequate screening examination, or malpractice action do not necessarily indicate an EMTALA violation; however, a violation can be cited even without an adverse outcome. There is no violation if a patient refuses examination &/or treatment unless there is evidence of coercion.

What are the provisions of EMTALA?

Hospitals have three main obligations under EMTALA:

Any individual who comes and requests must receive a medical screening examination to determine whether an emergency medical condition exists. Examination and treatment cannot be delayed to inquire about methods of payment or insurance coverage. Emergency departments also must post signs that notify patients and visitors of their rights to a medical screening examination and treatment.
If an emergency medical condition exists, treatment must be provided until the emergency medical condition is resolved or stabilized. If the hospital does not have the capability to treat the emergency medical condition, an "appropriate" transfer of the patient to another hospital must be done in accordance with the EMTALA provisions.
Hospitals with specialized capabilities are obligated to accept transfers from hospitals who lack the capability to treat unstable emergency medial conditions.

A hospital must report to CMS or the state survey agency any time it has reason to believe it may have received an individual who has been transferred in an unstable emergency medical condition from another hospital in violation of EMTALA.

How does EMTALA define an emergency?

An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs." For example, a pregnant woman with an emergency condition must be treated until delivery is complete, unless a transfer under the statute is appropriate.

[justbroke]

So the question you must ask yourself, is what exactly did the Healthcare Act do to the emergency medical act (EMTALA)? I mean, under the full Healthcare Act, it's cheaper for me to not carry insurance, pay the "fines" and just go to the emergency room. I would save 50% of what I pay now which is significant.

[malf1204]

Which is great unless you develop an illness that requites a course of treatment. The ER has to stabilize you but if you have cancer and need chemo that is not covered by the law.

[justbroke]

Which is great unless you develop an illness that requites a course of treatment. The ER has to stabilize you but if you have cancer and need chemo that is not covered by the law.

For EMTALA that is true. Under the Health Care Act, I think this issue may go away. I wouldn't give up my healthcare plan unless forced to. And, if forced to, I would just not carry it. I have a "choice" plan. It has been branded as "Cadillac" because I get to choose my doctors and specialists without any referrals. I travel for work and the ability to go see whoever I want, is very important to my life and work life. I haven't really used that option (maybe twice since 2000), but it's nice to know it is there.

When I was younger, sure, all i carried was catastrophic. Every company that I have worked for paid 100% for catastrophic coverage. Today I carry a really good plan because I just like the extra insurance. I do not think that I use more than $1,000/year in medical services. Alas, it's insurance. You get it in case something happens; if you have any luck, nothing will happen.

[GoingDown]

I do not have any health insurance. I'm still young enough and in good enough health where I do not need to see a doctor, nor take any prescription medications, so I don't need insurance at this point.

I had a health scare last year about this time, and I had to go use the health clinic at the Maricopa County Hospital. You have a sliding scale for fees based on income. It was a very long day, waiting, then filling out forms, then waiting, then talking to someone about the forms I filled out, then waiting, more waiting, and finally, I was able to see a nurse who ran some tests, took some body fluids, and then said "we'll call you about the results." 3 weeks later I called them about the results and fortunately the tests were all negative, and I was okay. The symptoms which led me to seek medical help had all gone away on their own.

I was lucky that time.

I changed my diet. Most of the time I am vegan or vegetarian, but on occasion I will go out to eat with friends and family, and I fall off my diet just for those occasions. I already get a lot of exercise because of my jobs, but now I added extra exercise on weekends, etc.

I am hoping that Obamacare will somehow survive the Supreme Court's republican majority, so I can finally afford to have health insurance. But if not, I will continue to use the Maricopa County Hospital when necessary. Their fees are reasonable because they are based on income. It's too bad other hospitals don't do the same thing.

I should point out that I used the health clinic, not the emergency room. I think the emergency room charges the full price.