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‘No Surprises Act’ goes into effect; Shreveport couple impacted by COVID hospital bills reacts

Published: Jan. 5, 2022 at 5:55 PM CST|Updated: Jan. 5, 2022 at 10:09 PM CST
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SHREVEPORT, La. (KSLA) - On Wednesday, Jan. 5, La. Senator Bill Cassidy spoke on his No Surprises Act, which establishes “consumers will have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers”, according to the Centers for Medicaid and Medicare Services.

“Surprised medical billing has either happened to you or to someone you know or it is going to happen to you,” Cassidy said. “You go in for an elective surgery from an in-network hospital but you’re not told until after the procedure that someone or something involved in your care was out-of-network or an ambulance takes you unconscious to an emergency room that’s outside of your insurance network. In cases like these, patients receive surprise medical bills that are ten-thousand, sometimes hundred of thousands of dollars that the insurance company won’t pay.”

Cassidy and a group of bipartisan lawmakers started working on the No Surprises Act in 2020 to end surprise medical bills. It was passed and went into effect on Jan. 1, 2022.

“The law protects patients from surprise medical bills for emergency services, post-emergency stabilization services, and non-emergency services provided by an out-of-network provider at an in-network facility,” said Cassidy. “Patients will only pay what they would if they are at an in-network facility. Now it does require health providers and insurers to work things out. It takes the patient out of the middle. If they want to fight, fight with each other. It’s a milestone in our effort to lower healthcare costs.”

Cassidy says too often, patients get blindsided by medical bills; he calls this a victory for patients. He adds the No Surprise Act can go towards COVID-related hospital bills. One study found that a person hospitalized with COVID could end up paying thousands of dollars in medical bills.

“Imagine you are brought to a hospital out-of-network or you to to an in-network hospital but the ER group has not signed a contract with the insurance company so you get a big bill for the out-of-network physician,” Sen. Cassidy said. “There are even instances that some equipment used can not be in-network. This bill addresses those situations. It also covers when you are about to go into an elective procedure and you are asked to sign a piece of paper before you’re rolled back stating you will pay any costs not covered by insurance. That could include a doctor who isn’t covered by your insurance and they can charge you whatever they want to charge you. This bill ends that practice.”

For people like Wendi and Johnny Winchel, this is great news. Both contracted COVID last year, but Johnny ended up with a worse case.

“He was diagnosed August 12,” Wendi said. “By then it had progressed so quickly he had to be hospitalized right away. They put him on the BiPAP machine for two weeks and he still was steadily declining. Every day he kept getting worse and worse and finally on August 26 the doctor came to me and say they had to put him on a ventilator immediately or he was going to pass that day.”

By that point, Johnny’s lungs were 80% filled with fluid and he was placed on a ventilator. He was given a 20% chance of survival.

“The next three weeks was touch and go,” Wendi said. “It was ‘he may make it through the night’ to ‘he may make it through the weekend’. We would have four really good days and them bam: he may not make it through the weekend. For three weeks it was a rollercoaster.”

Johnny started showing signs of improvement towards the end of September.

“When they placed the trach it was like a light switch flipped on,” Wendi said. “Improvement every day. It wasn’t much but it was baby steps.”

Johnny was able to me moved to an LTACH, or long-term acute care hospital in October and after 54 days, was taken off a ventilator. After five weeks they were moved to Willis-Knighton for rehab.

While the healthcare he’s been able to receive is invaluable, the bills do add up. The Winchel’s say they’ve only had a problem with one of their insurance companies, but they know many others who aren’t as fortunate.

“We haven’t started receiving too many of them yet,” Wendi said. “I’ve only received the bill from the first hospital, but thankfully insurance kicks in. He is retired military. It’s been very nice to have that and they have been great. They have approved anything and everything that we have asked for. My biggest goal was to get him where he needed to be. The rest I can worry about later. While we haven’t seen the other bills yet, we know they add up quick. One of his antibiotics was nearly $22,000 a bag and he had to have seven. I know some who have had COVID, passed and left that bill to their spouses. We know people who are struggling.”

Doctors told them Johnny will be able to go home next Tuesday to continue his recovery. Both say they are excited for when they can run their small business together again.

They say it’s been a long road to recovery, but they’re thankful for the treatment, as well as legislation like the No Surprises Act to help people like them.

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