Federal officials said if hospitals and other providers take emergency funds amid the COVID-19 pandemic, they will be barred from sending balance bills to COVID-19 patients. However, the broad terms HHS uses to describe COVID-19 patients has some analysts interpreting the text as a ban on all surprise billing, according to Kaiser Health News.
In the HHS terms and conditions for eligibility for the emergency relief funds, the agency uses the language: "HHS broadly views every patient as a possible case of COVID-19." When hospitals received the first wave of funding, they had to sign a form saying that "for all care for a possible or actual case of COVID-19," the provider wouldn't charge more out of pocket if the patient's insurance plan was out of network, a practice known as surprise billing.
Analysts are questioning whether the phrasing could in effect ban all balance billing during the pandemic at the federal level. The practice is banned in some states. Such a step would represent a huge change for the industry, as Congress to this point has been unable to come together on a nationwide solution for balance billing.
In a statement to Kaiser Health News, an HHS spokesperson said, "The intent of the terms and conditions was to bar balance billing for actual or presumptive COVID-19. We are clarifying this in the terms and conditions."
Read the full report here.
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