{{ Even though the drug had a list price of about $2,700, the hospital that owned the cancer center billed Mrs. King’s insurance company $22,700. Her insurer paid $10,000, but the hospital wanted more.
She got a bill for over $2,500 — “more than half my take-home salary for a month,” said Mrs. King, 65.
She had unknowingly sought care from a hospital that participates in a federal program allowing it to buy drugs at a steep discount and charge patients and insurers a higher amount, keeping the difference.
The company, Apexus, has worked behind the scenes to supercharge the program, according to interviews with current and former employees and emails, internal reports and other documents. }}
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Years ago when I was living in Houston, I happened to be watching one of those Sunday morning political shows and Texas Sen. Kay Bailey Hutchison was being interviewed on the topics of the day. A question was asked about a Medicare program for HIV patients where inexplicably something like 45% of the claims reimbursements under the nationwide program were going to Texas, while Texas obviously didn’t have 45% of the nation’s HIV patients, “Should this be investigated as a fraud?”
Kay Bailey, “Oh no. That would put more of a regulatory and enforement burden on business owners.”
Perhaps the company in question was a big campaign contributor? {[ LOL }}
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