Health care providers who receive emergency funds under the Coronavirus Aid, Relief, and Economic Security (CARES) Act are banned from the practice of “balance billing.” That’s according to an analysis by Kaiser Health News.
The question is whether that ban applies to coronavirus patients only, or all patients.
Balance billing is the controversial practice of hospitals and doctors accepting the negotiated reduced payment from insurance companies, but then billing the patient for the rest. It is banned in several states.
The CARES Act provides $100 billion in tax money to hospitals and health care providers dealing with the impact of the coronavirus epidemic. It stipulates that those who take the federal money cannot bill coronavirus patients for the balance after insurance.
But the restriction against balance billing may be even broader, according to some.
Kaiser Health News points out the small print found in the Department of Health and Human Services (HHS) terms and conditions for eligibility to receive funding says every patient is considered a possible case of Covid-19.
Care does not have to be specific to treating COVID-19. HHS broadly views every patient as a possible case of COVID-19.
CARES Act Provider Relief Fund,
Department of Health and Human Services terms and conditions
Even so, Kaiser says an HHS spokesperson clarified that the intent of the terms and conditions is to ban the practice of balance billing for actual or presumed COVID-19 patients only– but that legal challenges are likely since there is some ambiguity.
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