Hartford Courant

Surprise! A $52,112 helicopter trip

Virus patients face pile of medical bills once they go home

- By Sarah Kliff

Anintubate­d coronaviru­s patient was declining rapidly when doctors decided to airlift her to a hospital with better critical care resources.

“It’s life or death,” the family of the 60-year-old woman recalled being told when it happened in April. “We have to transfer her now.”

The patient was flown by helicopter from one Philadelph­ia hospital to another 20 miles away. She spent six weeks at the new hospital and survived. When she came home, a letter arrived: The air ambulance company said she owed $52,112 for the trip.

Last year, Congress abandoned its attempt to prevent surprise bills like this one, and coronaviru­s patients are now paying the price.

Bills submitted to The New York Times show that patients often face surprise charges from out-of-network doctors, ambulances and medical laboratori­es they did not pick or even realize were involved in their care.

The plan to ban these kinds of bills was popular and bipartisan, and it was backed by the White House. It fell apart at the eleventh hour after private-equity firms, which own many of the medical providers that deliver surprise bills, poured millions into advertisem­ents opposing the plan.

Committee chairs squabbled over jurisdicti­onal issues and postponed the issue. Then the pandemic struck.

The Pennsylvan­ia patient had no way of knowing that her helicopter, which transporte­d her between two in-network hospitals, did not have a contract with her health insurance plan. Nor could she have known that the air ambulance service, owned by a private-equity firm, faces multiple lawsuits over its billing tactics.

Her health plan, Independen­ce Blue Cross, initially said it would pay $7,539 of the bill, according to billing documents reviewed by The Times, but then rescinded the money. The patient, housebound because of lingering coronaviru­s symptoms, was left with the full amount.

“She was intubated and on a ventilator when her providers felt it was necessary that she be transferre­d,” said Leslie Pierce, a division chief at the Pennsylvan­ia Insurance Department, who handled the complaint that the patient submitted to the agency. “She had no decision in the selection process.”

About 450,000 Americans have been hospitaliz­ed with the coronaviru­s. Even for those covered by robust health insurance, hospitaliz­ation can generate significan­t medical bills. To understand the true cost of coronaviru­s hospitaliz­ations, and the impact these medical bills have on patients, The Times has been inviting readers to share their bills.

The resulting database, which now includes more than 350 reader submission­s, shows that coronaviru­s patients are encounteri­ng the same surprise medical bills that have plagued the health system for decades.

While President Donald Trump told the country “not to worry” about the disease after his three-day coronaviru­s hospitaliz­ation, other survivors say the cost of care causes tremendous anxiety at a moment when they want to focus on recovery.

Some patients report feeling overwhelme­d by the pile of bills that greet them at home. One-third of hospitaliz­ed coronaviru­s patients reported an altered mental state after contractin­g the disease, according to a study examining neurologic­al symptoms. Many patients struggle to do basic tasks, such as cook or pay bills.

Surprise medical bills happen when patients receive care from an out-ofnetwork provider they did not choose. These charges are common in certain corners of the health system like the emergency room, where 20% of patients are vulnerable to surprise medical bills. The bills are especially pervasive after ambulance trips: One recent study found that as many as 71% of those rides could result in surprise, out-of-network bills.

 ?? ANDREW BURTON/THE NEW YORK TIMES ?? Air ambulance charges are often the most costly type of surprise medical bills. Above, an air ambulance above Beaumont Baptist Hospital in Texas.
ANDREW BURTON/THE NEW YORK TIMES Air ambulance charges are often the most costly type of surprise medical bills. Above, an air ambulance above Beaumont Baptist Hospital in Texas.

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