NY coalition proposes first-in-the-nation cap on hospital clinic bills

A broad coalition in New York is supporting state legislation that would impose a first-in-the-nation cap on medical bills – aim of Hospitals that have outpatient clinics or private practices charge higher rates.

Under the “Fair Pricing Act”, patient billing costs for procedures for seniors would be capped at 150% of the rates set by the federal Medicare program.

A joint committee of the powerful building construction workers union Local 32BJ and a branch of the Real Estate Board of New York are handling a seven-figure media advertising blitz to drum up support for the bill.

“Two patients go to their local doctor’s office for the same procedure but pay very different prices. It’s happening all over New York as big hospitals are taking over independent doctors’ offices and raising the cost of routine procedures,” the 30-second TV ad says.

,Health care There should not be much cost since the building is owned by the hospital. The same fair price should be given for the same process.

The ad – paid for by the 32BJ Labor Industry Cooperation Trust Fund – gives examples that illustrate the glaring inequalities.

Currently, the bill for a child flu vaccine Advocates say it may be $23 at a doctor’s office, but at a hospital outpatient clinic, it’s $183.

The cost of giving IV fluids to a senior patient at a doctor’s office is $566, less than half the $1,719 charged at a hospital-run outpatient clinic.

The cost of an MRI to diagnose abdominal pain is $1,308 at a hospital clinic, more than double the $659 at a doctor’s office.

Groups supporting the proposed legislation include the NAACP, the Hispanic Federation, the Asian-American Federation, and the NY Immigration Coalition.

“Big hospitals are treating routine medical services like a game of monopoly, charging a higher price every time a patient walks into a building,” said Manny Pastrich, president of Local 32BJ of the Service Employees International Union.

“Our members rely on being able to go to their local doctor’s office to take their child for a flu shot, get an MRI for a stiff knee or get an IV bag for dehydration and not have to pay increased prices just because Will have to pay because it is a major disease. The hospital took over that facility.”

State Senator Liz Krueger (D-Manhattan), who chairs the influential Finance Committee, recently introduced the “Fair Pricing Act.”

“We cannot let big hospitals become the next Big Oil or Big Steel, with monopoly control over everything and forcing people to pay more for the same basic procedure. By capping the cost of outpatient services through the Fair Pricing Act we can level the playing field and ensure that patients have access to the same fair pricing wherever they go for their health care needs ,” Krueger said.

In addition to the strict cap, the measure would ban adding facility fees to routine outpatient services, thereby preventing hospitals from overpaying for doctors’ office services.

State agencies – including state attorneys general – will enforce the limits and impose fines for breaking the law and “deceptive practices.”

Advocates said lower medical expenses would make medical care more affordable for patients and insurers such as state and local governments and federal health funds.

Local 32 BJ said about 60% of doctors’ practices are hospital or corporate owned and about 80% of physicians are employees of hospitals or corporate entities.

If the bill is enacted, it would affect major hospital networks such as New York Presbyterian, Northwell and NYU Langone Health.

Lobbying group for hospitals opposes “terrible bill”.

“Hospitals and doctor’s offices are not the same. Only hospitals provide round-the-clock care and accept any patient who comes to their doors. Hospitals also are subject to myriad regulatory requirements that doctor’s offices are not, said Kenneth Ruske, president of the Greater New York Hospital Association.

Rakse said the bill “ignores” the financial pressures placed on hospitals.

“Does 32BJ have a magic wand that will eliminate severe Medicaid underpayments and the staggering number of payment delays and denials by insurance companies for benefits?” Raske asked.

“If the goal is to force New Yorkers to seek their care in Philadelphia, this bill will do that. Instead of pursuing harmful public policy, supporters of the bill should join the hospital community in fighting for higher Medicaid payment rates and rolling back the abusive practices of health insurance companies.