Source: NBC News New York.com
…Last August, Baer Hanusz-Rajkowski of Bayonne accidentally cut his finger with the claw-end of a hammer. He says he waited a few days for it to heal but the cut didn’t seem to be closing, so he went to the Bayonne Medical Center emergency room…
The nurse practitioner determined no stitches…or X-rays…were necessary, he says. (But) Hanusz-Rajkowsk got hit with an $8,200 bill for the emergency room visit. On top of that, Bayonne Medical Center charged $180 for a tetanus shot, $242 for sterile supplies, and $8 for some antibacterial ointment in addition to hundreds of dollars for the services of the nurse practitioner.
“I got a Band-Aid and a tetanus shot. How could it be $9,000? This is crazy,” Hanusz-Rajkowski said.
Dr. Mark Spektor, president and CEO of Bayonne Medical Center, blamed the high ER bill on Hanusz-Rajkowski’s insurance company — United Healthcare. Almost six years ago, a company called Carepoint Health bought Bayonne Medical Center…Carepoint did not renew its in-network pricing contract with United Healthcare. He says Hanusz-Rajkowski’s bill was so high because United fails to offer fair reimbursement rates…
But Mary McElrath-Jones, a spokeswoman for United Healthcare, suggested Carepoint is pursuing a predatory business model that avoids cutting price deals with insurers. “United Healthcare is deeply concerned about hospitals establishing an out-of-network strategy to hike the rate they charge for emergency room services, often surprising patients. Our members are very frustrated at receiving these egregious hospital bills, so we are working to curtail outrageous billing…”
New Jersey law requires insurers to pay for ER treatments, whether or not there is an in-network price deal.
The New Jersey Association of Health Plans, a trade association representing insurance companies, has argued Carepoint is effectively using a consumer protection law to price gouge emergency room patients. Ward Sanders, the association’s president is now calling for a price ceiling on emergency room procedures.
Carepoint has also purchased hospitals in Hoboken and Jersey City — turning them into for-profit ventures too.
Linda Schwimmer, vice president of the New Jersey Health Care Quality Institute, estimated the charge is more than ten times the true cost of treating a cut finger.
“(T)he right price is somewhere between…$400 and $1,000,” Schwimmer said. “And I know that because I’ve called around and asked, But why doesn’t everybody know that?” Schwimmer wants…a public database where average prices for medical procedures are available for reference.
United Healthcare has settled its portion of the bill, about $6,640. Hanusz-Rajkowski was responsible for the balance, but after questions from the I-Team, Spektor said the hospital has written off his portion of the debt.
Hanusz-Rajkowski said, “If I sever…a limb, (I’ll) carry it to the next emergency room in the next city before I go back to (that) place.”