COVID-19 Relief Act and Spending Bill is signed.

[audreyh1]

OK - the bill was signed tonight. You can now look forward to more stimulus.
https://www.forbes.com/sites/allbus...tant-things-you-need-to-know/?sh=37d08b38653b

Also ends surprise medical billing.

 

[NW-Bound]

Ending of medical billing surprise is excellent.

With the bill being more than 5,500-page long, I wonder if some new surprises may slip in.

 

[DrRoy]

Looks like the market will be pleased, at least to start today.

 

[MichaelB]

Here’s a good summary of all the spending and tax items in the package What's in the Final COVID Relief Deal of 2020? | Committee for a Responsible Federal Budget. There are many entries, including aid to state and local for vaccine distribution and COVID testing and tracking.

In addition to the new regulation of surprise medical billing, there’s also regulation to limit hydrofluorocarbons. Here’s a summary of everything in the bill from the NYT (paywall) https://www.nytimes.com/2020/12/22/us/politics/second-stimulus-whats-included.html

 

[Amethyst]

In our case....since we don't qualify for the checks.

OK - the bill was signed tonight. You can now look forward to paying for more stimulus.
.

 

[ivinsfan]

Didn't they lower the income limits this time around?

I read Michael B's link and it doesn't really speak to that.

 

[audreyh1]

In our case....since we don't qualify for the checks.

You edited my quote to change the meaning. Please don’t do that without something obvious like FIFY.

 

[ivinsfan]

You edited my quote to change the meaning. Please don’t do that without something obvious like FIFY.

I get your point... and in fact some of us are getting and paying and some of us are just paying.. what a world!

 

[Markola]

The end of surprise medical billing addresses one more absurdity we Americans have had to put up with from our unfair medical non-system. Good riddance.

 

[Montecfo]

I would criticize the pork included within the 5500 page bill however porky likes pork and he might visit.

 

[easysurfer]

I'd rather have the end of surprise medical billing than the stimulus.

Guess can't really complain because both are included .

 

[ivinsfan]

I'd rather have the end of surprise medical billing than the stimulus.

Guess can't really complain because both are included .

Remember they can still bill you, they just can't make it a surprise..

 

[Markola]

Remember they can still bill you, they just can't make it a surprise..

How is that supposed to work? Will we now start seeing ALL charges up front? If so, that’s enormous improvement over the ridiculous non-free market we face now, where no one knows any prices until the service is completed.

 

[ivinsfan]

How is that supposed to work? Will we now start seeing ALL charges up front? If so, that’s enormous improvement over the ridiculous non-free market we face now, where no one knows any prices until the service is completed.

They forgot to put that part in the bill...

 

[W2R]

I'd rather have the end of surprise medical billing than the stimulus.

Guess can't really complain because both are included .

I know I don't really NEED it, and that really I am the one who will have to pay for it (indirectly), but I can't help it - - I am still insanely happy about getting the stimulus. The idea of having a big wad of money just show up in my checking account like it did last time, totally floats my boat.

 

[Amethyst]

Does anyone know how to make text modifications (bolding, italics) show up in quotes? In an earlier post, I managed to mis-quote Audrey by adding two words, which I thought I had italicized. But my modification didn't take:

In our case....since we don't qualify for the checks.
Quote:
Originally Posted by audreyh1 View Post
OK - the bill was signed tonight. You can now look forward to paying for more stimulus.
.

What I meant it to look like was "In our case....since we don't qualify for the checks. 'OK - the bill was signed tonight. You can now look forward to paying for more stimulus."'

 

[REWahoo]

Does anyone know how to make text modifications (bolding, italics) show up in quotes?

Quotes are automatically italicized, so enclosing anything in italics within a quote does nothing. Bolding works (see above).

 

[audreyh1]

Quotes are already italicized - but even adding words and bolding would make it look like I had originally posted it and you were emphasizing part of something I had already said.

Better to post your own version in reply.

 

[Aerides]

Does anyone know how to make text modifications (bolding, italics) show up in quotes? In an earlier post, I managed to mis-quote Audrey by adding two words, which I thought I had italicized. But my modification didn't take:

Italics, as mentioned, are default. Best to strike-thru and add "FIFY" in the post so it's clear to all that you've made a change, since font highlights such as italics, bold, tend to mean only to emphasize the original text, and aren't clear to a reader that they are a re-write by the quote-r.

And yeah, in tricky situations, easier to quote straight up and then reply with your own. different wording if needed.

 

[audreyh1]

Remember they can still bill you, they just can't make it a surprise..

I suppose this is tongue in cheek, but that’s not quite how it works.

The insurer and provider have to battle it out. The provider can no longer turn around and bill the patient for the excess. The patient is not responsible in the cases covered by the law.

The patient can sign a waiver up front to allow out of network billing. So don’t do that unless you are deliberately accepting an out of network service.*

Many states already have this protection, some for a very long time, so it must be working at some level.

How is that supposed to work? Will we now start seeing ALL charges up front? If so, that’s enormous improvement over the ridiculous non-free market we face now, where no one knows any prices until the service is completed.

Exactly - although it doesn’t quite work that way as I explained above.

*Balance billing waiver form from Texas Department of Insurance (TDI): https://www.tdi.texas.gov/forms/lhlifehealth/ah025.pdf

 

[GenXguy]

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.

 

[Markola]

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.

 

[Aerides]

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...

 

[audreyh1]

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:

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/paulmcleod/suprise-medical-billing-banned-congress-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/aa...lance-billing-and-private-contracting-ppi.pdf

 

[Markola]

I stand corrected. Thanks.