Setting the Record Straight on Surprise Medical Bills

Claudia Knafo, a Families USA storyteller from New York City, submitted this letter to the editor of the New York Post in response to a May 9 article, “Lawmaker Wants to Limit Insurance Reimbursements to Healthcare Workers.” In the letter, Claudia details her harrowing experience after receiving a surprise medical bill. To read more about Claudia’s story, check out this interview she did last year about surprise medical bills with ABC News’ Start Here podcast.

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Mr. Stephen Lynch
Editor-in-Chief
New York Post
1211 Avenue of the Americas
New York City, NY 10036

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May 20, 2020

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Dear Mr. Lynch:

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Isabel Vincent’s May 9 article, “Lawmaker Wants to Limit Insurance Reimbursements to Healthcare Workers,” only offers one side of the surprise medical bill debate, that of health industry special interests, not my side of the story as a New Yorker and the story of thousands of families across the nation who have been financially devastated by surprise medical bills.

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For me, the surprise medical bill came as the result of critical spine surgery on April 12, 2012, that I needed to decompress my cervical spine. I had worked diligently with the doctor’s office manager, my insurance company, and the hospital’s patient services to make sure everything would be covered as in-network care. After receiving the surgery, however, the insurance company changed course, and, in the end, I was stuck with a bill for $101,000; it was financially devastating. As a result, I have had to write to the New York Department of Financial Services, I had to write to the attorney general of New York, and I consulted with a patient advocate attorney, all in the name of fighting for justice and getting us out of financial bankruptcy.

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And it is important to say that surprise bills continue, even during this worldwide pandemic. A few weeks ago, as I was quarantining in my home, I was called from an out-of-network doctor’s office to schedule a procedure. During the call, the doctor joined the call, got on the phone unsolicited. A few days later, I received a bill for $150 for “an out-of-network” phone call. Understand this was not a telemedicine visit; I was simply working with the office to schedule a procedure. And, now, during the pandemic, I have to fight yet another surprise medical bill.

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The bipartisan legislation described in the article by Ms. Vincent places the needs of families like mine before health care special interest groups, and would finally stop the devastating practice of surprise billing. The article unfairly described the legislation as creating “price controls.” That’s completely wrong. Experts have testified that this legislation uses a fair, market-based approach to settle claims promptly for the benefit of providers and insurers alike. Most importantly, the legislation would take families out of the middle of these fights between insurers and hospitals, and provide a level of certainty, which in times like these is sorely needed.

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And certainty around medical bills is needed now more than ever. Surprise medical bills have been an ongoing problem for consumers, but the threat is more significant due to COVID-19 as families are pushed to out-of-network care as in-network providers are swamped with COVID-19 cases and as hospitals contract with additional providers that are out-of-network to fill in the gaps. Nowhere in the nation is this more of a concern than in New York and for your readers given the devastating impact of COVID-19 in the New York community.

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COVID-19 is both a health and economic crisis. Establishing broad protections against all surprise medical bills will help ensure families can get the full spectrum of care they need and protect families’ financial security. These protections are about protecting families, not politics.

I hope Ms. Vincent will see this letter and consider hearing another side — that of the families trying to survive a pandemic and who stand to lose their health, homes, and livelihoods if Congress does not take immediate action to end surprise medical bills.

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Sincerely,

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Claudia Knafo
New York City