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Old 12-29-2020, 08:17 AM   #21
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The surprise billing protections don't take effect until January 2022.

It looks very similar to the protections in my state. A good thing over-all, even though it could certainly be better, compromises need to be made to get these things done.
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COVID-19 Relief Act and Spending Bill is signed.
Old 12-29-2020, 08:20 AM   #22
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COVID-19 Relief Act and Spending Bill is signed.

Thanks for the good explanation and, insurance executives and their lobbyists excepted, everyone else should be able to agree that this new provision is a step forward. I will refrain from more opinion, which inevitably gets political.
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Old 12-29-2020, 08:25 AM   #23
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I heard a good discussion about this surprise medical billing (and the changes don't go in effect until 2022). The change is only really to take the patient out of the equation.

Simply put:
You still pick a hospital and doctor, and go there, but still could have a scenario where the anesthesiologist was out of network and incurs an expense in your treatment. You can literally be unconscious and someone treats you but is out of network. That doesn't go away in this bill. The bill provides for a means for the insurer and provider to battle it out (arbitrations something?) without passing the expense on to the patient.

So the core problem is not solved, but everyone has agreed that punting it to the patient goes away...in 2022.

And...when you're bored, read up on the role private equity has played in compounding this issue...
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Old 12-29-2020, 08:25 AM   #24
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Originally Posted by Markola View Post
Thanks for the good explanation and, insurance executives and their lobbyists excepted, everyone else should be able to agree that this new provision is a step forward. I will refrain from more opinion, which inevitably gets political.
Actually, from what I read, the insurance lobbyists were fighting for this bill, and probably the main reason it passed. It was the provider lobbyists (including AMA) and private equity firms that have been fighting against it for years which is why no progress had been made in spite of strong bipartisan support.

If you want to know more about how the sausage was made:
Quote:
What started as a gap in the system was turned into a profit driver for private equity firms. Two private equity giants, Blackstone Group and KKR & Co., bought up the largest physician staffing firms which led to more doctors going out of network and charging exorbitant surprise bills.

These private equity firms then created a dark money front group called Doctor Patient Unity and spent tens of millions of dollars successfully opposing legislation to end private billing, denouncing it as “government rate setting.”
https://www.buzzfeednews.com/article...ss-coronavirus

FWIW Medicare severely limits balance billing.

Medicare’s Financial Protections for Consumers: Limits on Balance Billing and Private Contracting by Physicians PDF
https://www.aarp.org/content/dam/aar...acting-ppi.pdf
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Old 12-29-2020, 08:28 AM   #25
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I stand corrected. Thanks.
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Old 12-29-2020, 09:50 AM   #26
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I wonder what the average age of Congressional folks who are voting for the $2000? I am going to bet a lot of them are well over 60 and won't live long enough to have to pay it back. I'm all for helping those who have been harmed by government ordered shutdowns due to CV. But, many people (maybe most?) who get these stimulus checks don't need them. Like me.

The younger folks need to wake up.
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Old 12-29-2020, 10:16 AM   #27
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Originally Posted by audreyh1 View Post
Actually, from what I read, the insurance lobbyists were fighting for this bill, and probably the main reason it passed. It was the provider lobbyists (including AMA) and private equity firms that have been fighting against it for years which is why no progress had been made in spite of strong bipartisan support.

If you want to know more about how the sausage was made:

https://www.buzzfeednews.com/article...ss-coronavirus

FWIW Medicare severely limits balance billing.

Medicare’s Financial Protections for Consumers: Limits on Balance Billing and Private Contracting by Physicians PDF
https://www.aarp.org/content/dam/aar...acting-ppi.pdf
This is a perfect example of the maxium, don't ever look at the sausage being made.. you can't ever be too cynical about the connections between big business and government.
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Old 12-29-2020, 11:04 AM   #28
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Audreyh1, thanks for that background. It's a head shaker for sure.

Hope this legislation does fix it.
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Old 12-29-2020, 11:16 AM   #29
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Didn't they lower the income limits this time around?

I read Michael B's link and it doesn't really speak to that.
No.

The earlier CARES Act and this latest legislation both have the same income limits. Below these income limits, you get the full amount ($1200 for CARES, $600 for this latest bill). Above these limits, there is a 5% phase out, so for every $100 above the income limit, you lose $5 of the subsidy.

Some popular articles in the media are writing commentary to imply that the income limits have changed, though.

If you start with $1200 and remove $5 for every hundred dollars, the subsidy goes away at a certain level. If you start with $600 - half as much - and remove $5 for every hundred dollars, the subsidy goes away sooner. Twice as soon, in fact.

So the point at which the subsidy goes to $0 is lower with the latest legislation, but that is a consequence of starting with half the amount of stimulus in the current bill vs. the earlier CARES Act.
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Old 12-29-2020, 12:35 PM   #30
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No.

The earlier CARES Act and this latest legislation both have the same income limits. Below these income limits, you get the full amount ($1200 for CARES, $600 for this latest bill). Above these limits, there is a 5% phase out, so for every $100 above the income limit, you lose $5 of the subsidy.

Some popular articles in the media are writing commentary to imply that the income limits have changed, though.

If you start with $1200 and remove $5 for every hundred dollars, the subsidy goes away at a certain level. If you start with $600 - half as much - and remove $5 for every hundred dollars, the subsidy goes away sooner. Twice as soon, in fact.

So the point at which the subsidy goes to $0 is lower with the latest legislation, but that is a consequence of starting with half the amount of stimulus in the current bill vs. the earlier CARES Act.
Thanks, however as of this morning it might be 2K a person which would have the reverse happen.. stay tuned for further developments!
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Old 12-29-2020, 12:42 PM   #31
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...stay turned for further developments!
Which way should we turn?
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Old 12-29-2020, 12:46 PM   #32
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Which way should we turn?
typing on my phone...but it's kind of head spinning anyway...
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Old 12-29-2020, 01:00 PM   #33
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I'm hoping to get in on the stimulus again. Based on my 2019 income, I won't qualify, but my 2018 was much lower due to much higher retirement contributions in 2018. I received the first stimulus, and I filed a tax extension in April and filed my 2019 taxes on Oct 15, and I received a notice from the IRS about a week ago asking me to confirm the tax return is from me before they will process it. I have until Jan 8th to respond. So, I'm hoping my 2018 income will be used in determining my eligibility again.
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Old 12-29-2020, 02:32 PM   #34
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The younger folks need to wake up.
How dare you!
They don't have the time. Twitter, Facebook, Instagram, Pinterest, Tic-Tok, Snapchat, Reddit, Tumblr, WhatsApp, Linkedin, YouTube, etc

Full disclosure: I spend a lot of time on YouTube myself
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Old 12-29-2020, 04:50 PM   #35
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no one knows any prices until the service is completed.

Years ago, I had my lawyer draw up a document that says something like, "If you choose to include doctors, or other persons, that aren't in my coverage, plan on paying them yourself." I had the head of hospital sign that before any surgery. The one time they wouldn't sign, I went to another hospital.


Caveat emptor!
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Old 12-29-2020, 08:36 PM   #36
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I was getting spam from "AAPS" (Association of American Physicians and Surgeons) that blathered about how the bill was huge and full of pork (absolutely true, but irrelevant to why they were spamming). But they continued... Oh, by the way, we won't be able to sneak-in out-of-network services and charge unreasonably high fees that were never disclosed. They whined about having to go to arbitration or live with median in-network rates and said it was a step towards socialized medicine, rationing, and a race to the bottom. So just a bunch of scare words. I get it, if you're on the gravy train, you don't want anything to interrupt the flow. The US sick-care system is so heavily broken, this little band-aid, arriving a year from now, is good, but still a band-aid. In the mean time, nobody gets paid a thin dime until I have bills from all providers (you and all your contractors) and those bills are either in-network at negotiated rates, or at rates comparable to in-network rates.
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Old 12-29-2020, 08:59 PM   #37
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And...when you're bored, read up on the role private equity has played in compounding this issue...

Talk about “sick.” Private equity firms buy medical practices that are specifically out of network so that they can perform services then surprise patients with high bills. There’s a special place in hell for people who feed off sick people. I am 54 and I hope I live long enough to see the whole corrupt, fiendishly-complex sector replaced in this country. It really is untenable.
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Old 12-29-2020, 09:42 PM   #38
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Talk about “sick.” Private equity firms buy medical practices that are specifically out of network so that they can perform services then surprise patients with high bills. There’s a special place in hell for people who feed off sick people. I am 54 and I hope I live long enough to see the whole corrupt, fiendishly-complex sector replaced in this country. It really is untenable.
You are going to need to live a really long time, maybe forever.
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