May 8, 2017 - Suzanne Potter, Public News Service (NV)
Depending on the hospital, seniors on Medicare may not get the lower Medicare rates if they're injured in an accident where someone else is at fault. (AARP)
CARSON CITY, Nev. - A hearing will be held this week for AB 183, a bill that would make sure seniors are charged lower Medicare rates by hospitals if they are injured in an accident in which someone else is at fault.
Right now, some hospitals in Nevada charge patients for the full bill rather than the lower Medicare rates, based on the assumption that the victim will hire a lawyer to go after the responsible party's insurance company. Bill Bradley, a consumer trial lawyer in Reno and a member of the Nevada Justice Association, said seniors on Medicare should get the benefit of the lower rates Medicare has negotiated.
"Medicare agreed to pay the bills on behalf of these people," Bradley said. "These people paid for their Medicare contract, and for the hospital to unilaterally decide that it doesn't have to bill Medicare is unfairly taking advantage of our senior citizen population."
Bradley said many hospitals refuse to bill Medicare in these cases. The University Medical Center of Southern Nevada in Las Vegas is an exception.
If the patient recovers money from the other person's insurance company, the patient will have to pay Medicare back.
Opponents of the bill say hospitals have the right to refuse to bill Medicare because the patient has the right to sue for the full amount of the bill. But Bradley argued that if the responsible party only has the minimum insurance coverage of $15,000, the patient is responsible for paying the rest.
"Where there is not adequate insurance, lawyers try to approach these hospitals and explain that there wasn't adequate insurance and ask the hospital to reduce its amount," he said. "And sometimes the hospitals are willing to negotiate, and other times they aren't."
According to Bradley, there is no national standard on how to deal with these types of situations. Rather, other states take a variety of approaches to the problem.
The bill will be heard before the Assembly Judiciary Committee at 9 a.m. on Tuesday.