Congressional investigators look at COVID-19 billing at 2 Okla. hospitals

BY PAUL MONIES
Oklahoma Watch
07/11/2020 10:00 AM
Main Cherokee Phoenix
Congressional investigators looking into COVID-19 billing practices have sent letters to the Oklahoma ER and Hospital in Oklahoma City and a sister hospital in Tulsa seeking more information about test prices and surprise billing. MIKE SHERMAN/OKLAHOMA WATCH
Main Cherokee Phoenix
Oklahoma Watch is a nonprofit, nonpartisan media organization that produces in-depth and investigative stories on important issues facing the state. For more Oklahoma Watch content, go to oklahomawatch.org. COURTESY
Two small hospitals in Oklahoma City and Tulsa are among 10 facilities being contacted by congressional investigators over the price of COVID-19 testing and reports of surprise medical bills.

U.S. Rep. Frank Pallone Jr., a New Jersey Democrat who is chairman of the House Energy and Commerce Committee, sent letters on July 1 to Tulsa ER and Hospital and Oklahoma ER and Hospital in Oklahoma City. Both are affiliates of Houston-based Nutex Health, which runs 19 standalone ERs and hospitals in eight states.

Pallone said he was concerned about reports of surprise bills and higher-than-expected charges for COVID-19 tests and related services. 

“As a result, I am seeking further information about the price that your company is billing issuers and consumers, both uninsured and out-of-network, for COVID-19 diagnostic and serological tests and related items and services,” Pallone wrote in the letters.

Dr. Christion Rice, managing partner for the Oklahoma hospitals, said they are investigating the allegations in the committee’s letter. Rice said the hospitals’ websites list a cash price of $200 for a COVID test. That does not include the cost of the ER visit and physician evaluation, which varies based on the patient’s need and symptoms. He said the hospitals don’t balance-bill patients for COVID-related services. Balance billing is where providers bill patients directly if insurers don’t cover a service.  

“In addition, we are holding patients harmless with regard to all COVID testing and treatment,” Rice said in an email. “We strive to be compliant with the CARES Act, and we consistently review our billing process for compliance. If an insurance carrier does not cover obligated expenses for COVID testing and treatment, we will not bill these expenses to patients and will absorb these costs. Our emergency room charges are comparable or below the prevailing charges in the region.”

Pallone said the Families First Coronavirus Response Act, passed in March, requires individual and group health insurance plans to provide benefits for some items and services related to COVID-19 testing without any cost-sharing requirements. The Energy and Commerce Committee has oversight over the law. 

“The committee has been informed of troubling instances in which providers are charging up to $6,000 for one COVID-19 test,” Pallone wrote. “In a number of instances identified to the committee, providers are charging prices for diagnostic tests to detect COVID-19 that range from $300 to $6,000.”

The Centers for Medicare and Medicaid Services’ latest payment rate for COVID-19 tests is around $100.

Alex Gerszewski, a spokesman for state Attorney General Mike Hunter, said the attorney general’s consumer protection unit has not received any COVID-19 billing complaints about the Oklahoma City or Tulsa hospitals named in the congressional committee’s letters.

The Oklahoma City hospital, located at 15103 Pennsylvania Ave., is licensed for four beds and the Tulsa hospital is licensed for eight beds, according to the latest hospital directory compiled by the Oklahoma State Department of Health. The Oklahoma City hospital has been open since early 2019, and the Tulsa hospital has been open about a year, Rice said. As so-called “micro hospitals,” they offer around-the-clock care and outpatient services. 

Unlike states like Texas, Oklahoma does not allow free-standing ERs that aren’t affiliated with a hospital. The Legislature considered a bill in 2018 that would allow free-standing ERs. The measure, House Bill 3230, passed a House committee but did not get a vote on the floor. The State Chamber of Oklahoma and the Oklahoma Hospital Association were among the opponents of the bill.

Pallone requested responses from the companies by July 10. The committee sent similar letters to freestanding ERs in Texas, a lab in New Jersey and the Austin, Texas-based National Association of Freestanding Emergency Centers.

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