NJ hospital charges insured patient $89K for two cortisone shots

A troubled hospital in New Jersey is rejecting its current payer contracts and engaging in balance billing patients, sometimes for tens of thousands of dollars, according to the Bergen County Record.

Meadowlands Medical Center, which is owned by a company called MHA, has come under fire from some consumer advocates for being one of the most expensive hospitals in the United States. It has tried to collect its full chargemaster prices from patients insured by UnitedHealthcare, and has sent out about 200 collection notices to patients for care rendered in 2011, the article said. 

In one instance, patient Ashok Vaidya received an $89,000 bill for two cortisone shots, procedures that at UnitedHealth's negotiated rate would have been around $2,800, according to the Record. In another instance, a patient received a bill for more than $102,000 for care the hospital provided.

Meadowlands has the highest charge-to-cost ratio in the nation, imposing bills on average that are more than 11 times the actual cost of delivering care, according to the National Nurses United.

Hospitals in New Jersey taken over by for-profits often experience a financial turnaround when the new owners attempt to invalidate its payer contracts, according to the Record. In Meadowlands' case, it reported an $11 million profit in 2011, a year after it changed hands. In 2010, it had lost more than $10 million.

For-profit hospital operators and chains, such as Prime Healthcare Service, often reject payer contracts. In 2008 the California Department of Managed Health Care sued Prime's owners to get them to cease and desist the balance billing of insured patients, FierceHealthcare previously reported.

MHA agreed to conditions imposed by the state to keep payer contracts in place for at least a year after it took over Meadowlands. But the hospital's attorney contacted United and stated in a letter that the hospital "can no longer afford to treat your clients' enrollees essentially for free," the Record reported.

Meanwhile, Meadowlands has paid thousand of dollars of fines to state regulators for late filing of financial reports and is currently subject to liens from the Internal Revenue Service totaling millions of dollars.

To learn more:
- read the Bergen County Record article

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