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Are hospitals billing COVID-19 patients? Here’s what we found out.

Coronavirus

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EastIdahoNews.com file photo

IDAHO FALLS — Over the last few months, COVID-19 has turned the country on its head, and there is so much conflicting information about it, it’s hard to tell what’s real and what isn’t.

One of the most common rumors EastIdahoNews.com hears is that hospitals are making a tremendous amount of money off COVID-19 and that some patients who are hospitalized with the virus are getting bills for hundreds of thousands of dollars. We spoke to hospitals and found out that none of that is true.

In fact, local hospitals are not billing patients for COVID-19 testing or hospital care — even if the patient doesn’t have insurance.

Here’s how it works.

On March 27, 2020, an over $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed by Pres. Donald Trump. The full CARES Act is 880 pages.

In the CARES Act, $100 billion in relief funds were allocated to help hospitals and health care providers on the front lines of the COVID-19 response.

To be eligible to have received a payment initially, a provider must have billed and accepted payment for services from Medicare during 2019. Additionally, the provider must have diagnosed, tested or cared for patients with possible or actual cases of COVID-19 after Jan. 31, 2020, according to the U.S. Department of Health and Human Services.

In Idaho, 1,242 Idaho providers have received payments, which equals $290.48 million, the U.S. Department of Health & Human Services TAGGS reports.

Providers can accept or reject the CARES Act funds, but it has to be done within 90 days of receiving the payment.

The CARES Act and local hospitals

Our local hospitals were among those organizations that accepted those funds. The funding allowed them to ramp up a variety of services to prepare for any possible surge in patients, and cover any lost revenue caused by fewer non-COVID-19 patients using hospital services.

Eastern Idaho Regional Medical Center spokeswoman Coleen Neimann said HCA Healthcare — which owns EIRMC — received CARES Act funds. However, HCA hospitals such as EIRMC did not individually apply for the funding. HCA has received about $1 billion in bailout funds since the start of the pandemic.

HCA owns 184 hospitals and approximately 2,000 urgent cares, surgery centers and clinics nationwide and has not specified how that money was divided among them.

Idaho Falls Community Hospital, which is locally owned, was given less than $1,000 in CARES Act funding, hospital’s spokeswoman Natalie Podgorski said. Most of the funds were distributed based on 2018 and 2019 revenue information that the Center for Medicare and Medicaid Services already had on file, she said. The hospital opened at the end of 2019, which is why Podgorski said it only received a few hundred dollars.

“While we received a small amount, we still needed to agree not to use any of the funding for lobbying and other excluded purposes,” she said in an emailed statement. “We have closely tracked how the money was used.”

Madison Memorial Hospital spokesman Douglas McBride said his hospital received $1.5 million.

Other providers in eastern Idaho received funds, including Pocatello Hospital LLC (Portneuf Medical Center) with $4,297,625, Idaho Neurosurgery and Spine Pllc with $56,635, and $100,295 to Solace Healthcare. A public list of providers that received one or more payments and agreed to the terms and conditions can be found by clicking here.

The funds do not need to be repaid.

How are local hospitals billing COVID-19 patients?

By accepting funds from the CARES Act, local hospitals have agreed not to directly bill patients for COVID-19 testing or care.

The hospitals can still collect funds from insurance companies for COVID-19 testing and treatment, but officials at EIRMC, Idaho Falls Community Hospital and Madison Memorial Hospital all agree that the patient portions, such as a copay or deductible, is dropped and the patient themselves never see a bill. Podgorski and McBride said even if the full cost of COVID-19 care is not covered by a patient’s health insurance, the patient won’t need to pay.

For patients that have no insurance at all, hospitals can be reimbursed for COVID-19 testing and treatment from a portion of the $100 billion designated for the uninsured. Those hospitals will be reimbursed at Medicare rates for those patients. Those rates may vary somewhat between city and state, according to an article by USA Today, depending on national and regional trends, including labor costs and health care resources.

Hospitals that accept CARES Act funds are allowed to collect these reimbursements, and they agree not to charge patients directly.

According to the Kaiser Family Foundation, a nonprofit organization focusing on national health issues, reimbursing hospitals could cost between $13.9 billion and $41.8 billion.

Some patients were billed prior to legislation

Local hospitals say that given the timeframe they have been testing and treating COVID-19, there were some patients who did pay for treatment before the national legislation was drafted.

Niemann said EIRMC is in the process of refunding a small number of patients who received bills and made payments for COVID-related hospital care before they implemented the policy in April. Podgorski said they’ve been working diligently to make sure they flag all patients who have gone to the community hospital because of COVID-19. If a patient did receive a COVID-19 bill, she said they should call the billing department immediately at (208) 528-1000.

McBride added that some Madison Memorial patients were charged for COVID-19 tests, but are also getting reimbursed.

Are insurance companies getting money for COVID-19?

EastIdahoNews.com spoke with Blue Cross of Idaho and PacificSource Health Plans. Neither of the major insurers has received any CARES Act funding to help with the costs. But they are covering COVID-19 testing and treatment like any other medical issue and making sure their clients don’t have to pay.

CBS News reported that dozens of insurers have waived co-payments, co-insurance and deductibles for all COVID-19 testing and treatments. Spokesmen for Blue Cross of Idaho and PacificSource Health Plans both confirm that to be the case at their companies.

“We are following all requirements under the CARES Act, as well as instituting our own policies to assist our members during this troubling time,” PacificSource Health spokesman Lee Dawson said in an emailed statement to EastIdahoNews.com.

Contact your insurance company if you have questions regarding your insurance or any bills you may have received.

For more COVID-19 news click here.

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