The UFT has mounted a campaign in Albany this spring to pass legislation that would help rein in spiraling health care costs by barring hospitals from charging outrageous fees for emergency care to out-of-network patients.
“We can’t allow hospitals to consider a medical emergency and an out-of-network emergency room admission as an excuse to price gouge,” said UFT President Michael Mulgrew. “We are pushing Albany to pass a bill that says enough is enough in the state of New York.”
Patients — even union members with quality health coverage — end up paying for these charges. When insurers pay more for exorbitant out-of-network costs, patients end up paying more in the form of higher rates the following year. When their employers pay the higher health care premiums, as is the case with DOE-employed UFT members, patients still lose because higher health care costs mean less money for pay raises.
New York passed a law in 2014 that allows patients to dispute those kinds of charges by emergency room physicians through a binding arbitration process. Doctors’ bills for out-of-network emergency room care have since declined by 34 percent, according to the Patient Protection Coalition, a collection of consumer, labor, business and health care organizations pushing for this legislation.
But emergency out-of-network hospital charges were not included in the legislation, and these fees can account on average for 80 percent of a bill, according to the coalition, which includes the UFT.
So a broken leg treated with an out-of-network emergency hospital admission can cost a staggering $221,000, or 316 percent above market average charges, according to data gathered by the coalition. A first- or second-degree burn treated in an out-of-network hospital emergency room can cost $184,392, or 491 percent above average market charges. And a heart attack in an out-of-network hospital emergency room can cost $145,397, or 84 percent above the average market charge.
The new bill in Albany, A-264-B/S-3171-A, would extend the existing independent arbitration process to all emergency-room charges and resulting hospital admissions, including patient processing, intravenous fluids and blood transfusions. The bill would not apply to safety-net hospitals, which provide a significant level of care to low-income, uninsured and vulnerable populations.
The New York State Foundation, an independent group, described the existing arbitration process for emergency room doctors’ fees as leading to “significant progress in protecting patients from surprise bills.”
“You may not see it,” Mulgrew told delegates at the Delegate Assembly on May 22, “but when I go to the negotiating table, all these bills are sitting at the table.”