Latest news with #CynthiaFisher
Yahoo
17-06-2025
- Business
- Yahoo
‘This was a principle thing': Colorado man fights back after emergency hospital stay results in $104K bill
Blake Pfeifer of Colorado Springs is calling on hospitals to uphold their legal requirements for transparent pricing. Pfeifer underwent emergency stomach surgery at the University of Colorado Health Memorial Hospital Central in 2022 and was surprised when bills for his week-long stay just kept coming. Thanks to Jeff Bezos, you can now become a landlord for as little as $100 — and no, you don't have to deal with tenants or fix freezers. Here's how I'm 49 years old and have nothing saved for retirement — what should I do? Don't panic. Here are 6 of the easiest ways you can catch up (and fast) Nervous about the stock market in 2025? Find out how you can access this $1B private real estate fund (with as little as $10) 'We literally had bills scattered all over the floor and it covered the entire office,' Dawn Pfeifer, Blake's wife, shared with NBC News. Pfeifer was originally charged $104,000 for his hospital stay, which was reduced to $58,124 as he would be paying out of pocket. However, more bills kept arriving, and Pfeifer's attempts to contact the hospital for clarity on the charges reportedly went nowhere. 'I've always paid my bills,' Pfeifer, 63, told NBC News. 'I wanted a little better explanation.' Unfortunately, patient advocate groups say that Pfeifer's experience is quite common. 'Hospitals and insurance companies alike have even hired many middle-player firms to be able to maximize their margins and profits at every single patient encounter,' Cynthia Fisher, founder of told NBC News. 'Sometimes what we're finding is the charges like Blake's that are billed are far beyond even the highest rate that they have within their hospital pricing file.' Fisher told NBC News that hospital billing systems seem to be 'intentionally complex.' NBC noted that under Colorado law, hospitals that violate the federal price transparency rule — which went into effect in 2021 — are liable to be penalized for deceptive trade practices. The law requires hospitals to clearly state pricing on their respective websites. However, NBC News found that a number of Pfeifer's bills are higher than the hospital's listed prices, including $99 for a blood culture that was listed between $8 and $61 for insured patients, and $104 apiece for a series of 10 blood tests that should cost anywhere between $6.52 and $52.89 per test, based on the hospital's website. In fact, NBC News found that only 25% of the charges Pfeifer received were listed on the hospital's required price list. 'What happened to Mr. Pfeifer unfortunately repeats itself and plays out across the country thousands of times every year,' said Steve Woodrow, Pfeifer's lawyer and a Democratic member of the Colorado House of Representatives. 'We now have a situation where people are afraid to get medical care because of the financial ramifications.' Dan Weaver, a spokesman for UCHealth, said in a statement shared with NBC News that the health system 'does everything possible to share prices and estimates with our patients, encourage insurance coverage, assist patients in applying for Medicaid and other programs that may offer coverage.' Read more: Want an extra $1,300,000 when you retire? Dave Ramsey says — and that 'anyone' can do it NBC found that the Centers for Medicare & Medicaid Services (CMS) had penalized only 27 hospitals for non-compliance with transparent billing practices in the last four years since the law took effect. However, the Department of Health and Human Services Office of Inspector General found in 2024 that only 63 out of 100 hospitals studied were up-to-date with price transparency requirements. Furthermore, a study from The Commonwealth Fund found that over 45% of working-age adults in the U.S. who had insurance were charged for a health service that they thought was covered by their insurer. NBC also interviewed Damon Carson, a small-business owner in Colorado who was sued by a collection company after he refused to pay the additional bills that started rolling in after his outpatient endoscopy at a UCHealth hospital. Carson was originally quoted $1,448 for the procedure and paid upfront, out of pocket, but was later charged an additional $4,742. In mediation, his additional bills were reduced by one-third to settle the case. 'I was surprised they caved that fast,' Carson told NBC News. '[My wife] and I could easily have paid the $4,000 and our lives gone on. But this was a principle thing.' The American Journal of Managed Care reported on 'pervasive billing errors' and 'aggressive tactics' in the health care and insurance industries in 2024. Dr. Jeffrey Sippel, associate director of inpatient clinical services and associate professor of clinical medicine in the Pulmonary Sciences and Critical Care Medicine Division at the University of Colorado School of Medicine, said he's been overwhelmed with denied insurance claims from Medicare Advantage plans. 'It's driven by money,' said Sippel in an article on The American Journal of Managed Care's website. 'It's driven by a lack of appreciation of how dynamic these patients are, and how quickly they can change from sort of stable to doing quite poorly.' These overbilling practices are all the more troubling considering how much the federal government spends on health care in the United States. Data from the World Health Organization shows the U.S. government spends approximately double what other G7 nations spend on health care per citizen. In 2021, the U.S. spent $12,000 per person on health care while the average spend for other G7 countries was between $4,400 and $7,600. Canada, for example, reportedly spent $6,600 per person on health care, while the U.K. was at $6,200 per citizen. So, what can you do if you find yourself with additional bills piling up after a hospital stay? In Colorado, patients can sue a hospital for instigating debt collection proceedings against them if they believe the hospital violated price transparency laws. If you find yourself in a dispute over a hospital bill, advocate for yourself and insist on a clear explanation of your charges. In fact, Fisher has some strategic advice for anyone facing charges after a stay in the hospital. 'No one should ever pay that first bill,' she told NBC News. 'The onus of proof needs to be on the hospital and the insurance company to prove that they have not overcharged us.' The CMS also advises patients to shop around for their health care and compare prices and price transparency practices between hospitals to avoid higher-than-necessary bills. Finally, it's best to keep your primary care physician involved in the process, as they may be able to help advocate for you and offer additional information on finding accessible health care. Rich, young Americans are ditching the stormy stock market — here are the alternative assets they're banking on instead Robert Kiyosaki warns of a 'Greater Depression' coming to the US — with millions of Americans going poor. But he says these 2 'easy-money' assets will bring in 'great wealth'. How to get in now This tiny hot Costco item has skyrocketed 74% in price in under 2 years — but now the retail giant is restricting purchases. Here's how to buy the coveted asset in bulk Here are 5 'must have' items that Americans (almost) always overpay for — and very quickly regret. How many are hurting you? Like what you read? Join 200,000+ readers and get the best of Moneywise straight to your inbox every week. This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
Yahoo
10-06-2025
- Health
- Yahoo
Hidden charges? Patients often face massive bills when Florida hospitals don't provide costs upfront
A Jacksonville woman posted on Facebook a $3,000 hospital bill for an MRI of her foot. 'Paying $3,000 for something that costs $400 … pretty absurd,' she wrote. For Floridians, knowing how much a procedure costs before getting hit with a humongous hospital bill can be the difference in whether someone struggles for years with medical debt. Now, Florida's attorney general announced he is launching an investigation to ensure hospitals provide patients with transparent pricing for medical services. Florida hospitals are supposed to make it easy for patients to know costs upfront and compare prices. However, it is not happening in the way federal and state laws require. Try to compare the cost of a chest X-ray or colonscopy at hospitals anywhere in the state and you will discover that many fail to provide clear and accessible pricing information on their websites. 'Hospitals know the prices to the penny, and the amount of profit they will make,' said Cynthia Fisher, founder and chair of 'They know what insurance plans pay and the cash prices. Yet, it is egregious and deceptive and unfair to make every patient sign that they will financially cover whatever the hospital chooses to charge them without knowing what the cost will be.' Shoppers in Florida are savvy consumers, comparing prices of property insurance, gasoline and cruise vacations. However, when it comes to price shopping for healthcare services, many Floridians are unaware that, before they get care, by law, they should be able to compare prices at different hospitals or look up cash versus insurance prices within the same hospital for a medical procedure or service. Patient advocates say hospitals often require that patients give their electronic signature — accepting full financial responsibility — without providing them any information on prices. 'If one hospital charges $3,000 for an MRI and another charges $7,500, that difference is a lot of money to a family,' Fisher said. At a time when many people choose high-deductible insurance plans, 'it matters to have price competition,' she adds. It also matters because nearly two-thirds of Americans delay care each year for fear of financial ruin. President Trump mandated in 2021 that hospitals and insurers make prices public for 300 shippable medical services. However, it isn't happening. Changes under the Biden Administration rolled back key price transparency requirements, allowing hospitals to post estimates rather than actual prices. Trump's new order, signed in February, said that hospitals and health plans 'were not adequately held to account when their price transparency data was incomplete or not even posted at all.' The president wants to create rules that will boost enforcement to increase hospital compliance and force hospitals and health insurance companies to make it easier for patients to compare the actual prices of procedures and prescription drugs. Florida Attorney General James Uthmeier's investigation aligns with Trump's recent efforts. It draws on Florida law, which states that unfair and deceptive acts and practices are 'unlawful,' including the omission of material information, such as prices. On the website of every hospital in Florida, a 'price transparency' link at the bottom will guide you to a tab that provides information on costs for services. The amount of information and the ease of accessing it vary. Many price lists are so incomplete or difficult to navigate that it is nearly impossible to figure out an actual price, conduct a rigorous comparison between hospitals, or fully compare the rates negotiated by two major insurers at the same hospital. Often, a link on the page requires a visitor to download pricing spreadsheets that are voluminous, complex, and difficult to understand. A December 2024 report by found that most hospitals in Florida are not complying with the federal rule requiring them to publish their discounted cash prices and all negotiated rates by insurance plan for all services. The organization found only 29% of hospitals in Florida are fully compliant with the federal price transparency rule — that's only 39 of 135 Florida hospitals reviewed. And only 3% of the 135 Florida hospitals reviewed provided sufficient pricing data to consumers. The report revealed wide price variations for the same service, even within the same hospital system. It found hospitals posted files that did not include all payer and plan names, or files that did not include accurate minimum and maximum negotiated charges 'By keeping their prices hidden, hospitals continue to block consumers from their right to compare prices and protect themselves from overcharges,' Fisher said. 'Over 92% of healthcare is planned. Scheduled. We, by law, are supposed to have prices before we receive care.' Ilaria Santangelo, director of research at PatientRightsAdvocate, said that Florida's insufficient transparency mirrors a national lack of transparency. Of 2,000 hospitals in the U.S. reviewed by the organization, only 335 hospitals (16.8%) were found to be sufficient in their disclosure of dollars-and-cents prices. 'The rest of them posted unaccountable, incalculable prices,' Santangelo said. 'What good is a pricing file that doesn't contain prices?' To help patients navigate healthcare costs, Florida offers the Health Price Finder tool. You can search by procedure name, select locations (county, city, zip), and see a comparison of average or typical charges. The finder, though, provides cost estimates and averages that may vary from actual charges. 'An estimate can be off by thousands or tens of thousands of dollars,' Santangelo said. 'Averages are not real prices. What happens when you are charged an above-average price? How do you dispute that?' Matt Ungs, founder of Patient Fairness, said he regularly receives calls from Floridians outraged by hospital bills exceeding six figures. '(Hospitals) are relying on people to shrug and pay the bill, but the more people who push back, the more likely hospitals will change their conduct,' said Ungs, whose company disputes medical bills for clients. A Central Florida woman who received an outrageous bill made national headlines a few years ago, drawing empathetic responses. In December 2021, Bisi Bennett ended up with a hospital bill for more than a half-million dollars after giving birth — despite having health insurance. Her son was born prematurely at Advent Health Orlando and rushed to the NICU, where he had a two-month stay. During that time, Bennett's employer changed health plans. The hospital billed her $550,000. After numerous calls to straighten it out, she was sent the same bill again, with a payment plan of nearly $46,000 a month. After a media inquiry, the hospital lowered the bill to just $300 total. Fisher said her organization wants to protect patients from overcharges and force hospitals to follow federal and state law. Under the Florida No Surprises Act, patients have the right to a Good Faith Estimate, which is an estimate of the cost of services. It offers protection from unexpected, or surprise, bills when a person receives care from out-of-network providers at in-network facilities. Ungs said while estimates are helpful, knowing the exact cost in advance is more useful. 'Patients have a right to real prices, and they need to start demanding them. You can only fight an overcharged bill with an actual price, not an estimate.' On May 30, Florida's attorney general released a video on X in which he addresses Floridians about Trump's actions to enforce price transparency. 'My office is going to help the President deliver on his mandate,' Uthmeier said. Subpoenas are part of an investigation 'related to patient charges, disclosures, billing practices, price transparency, and surprise billing protections,' he said. The hospital systems targeted by Uthmeier's subpoenas include AdventHealth, with more than 30 hospitals in Florida, and Southern Baptist of Florida in Jacksonville, with about a dozen hospitals in the state, according to Fox Business. Neither health system responded to requests for comment or to answer questions about the subpoenas or their efforts for price transparency. Southern Baptist of Florida's website appears more transparent than many others in the state. It provides a tool to estimate costs, even for those who are not existing patients. It can be searched by insurance plan or cash. The tool offers a good example of why a patient would want to shop around: For a procedure such as a colonoscopy, cash prices differ between hospitals within the Southern Baptist system — a colonoscopy at Baptist Clay is $5,121 and at Baptist Jacksonville, $5,546. Uthmeier would not provide any confirmation or elaboration on which Florida hospitals received subpoenas, whether those hospitals will receive fines, or how he plans to enforce price transparency rules. Numerous requests from the South Florida Sun Sentinel for more details went unanswered and a request for an interview was denied. Jaime Caldwell, president of the South Florida Hospital and Healthcare Association, said local hospitals have devoted time and resources to make price tools consumer-friendly. They have had much to overcome and still have more work to do, he said. 'Hospitals need to better integrate their IT systems to make the required data more readily available … these improvements are happening,' he said. 'It's a long road and hospitals have made the journey toward providing their patients with the financial information that they want to make an informed decision.' A spokeswoman for the Cleveland Clinic of Florida offered this written response about price transparency: 'For patients to understand their potential financial obligation for care, it is recommended to first check with their insurance provider, who has access to all of the detailed information about their personal coverage. Estimates for care are available to patients when scheduling surgical and diagnostic services and upon request for all other services.' It was noted that patients can access their own estimates for 300 services through their MyChart account or the Cleveland Clinic's website. 'Our financial advocates are also available to help patients understand and calculate their potential financial obligations before they receive care,' the spokeswoman said. After Uthmeier announced his investigation into hospital price transparency, Mary Mayhew, president/CEO of the Florida Hospital Association, provided the South Florida Sun Sentinel a written response: 'Florida hospitals have invested time and resources to develop responsive, easy-to-use tools to deliver meaningful, consumer-friendly pricing information: providing patients with straightforward, personalized, and actionable information based on their specific insurance coverage and financial circumstances,' she said. 'Florida hospitals are deeply committed to preserving and enhancing the health and well-being of the communities they serve, and working collaboratively with local and state leaders to advance this shared vision of an affordable, accessible, efficient and high quality health care system.' The push for price transparency comes as roughly 100 million Americans are currently in debt due to medical costs, representing the nation's leading cause of personal bankruptcy, according to KFF Health News. Patient rights advocates said no one should pay a hospital bill without an itemized list of costs. In Florida, under the Patient's Bill of Rights, you can obtain that list, but you must request it. Price variations within a hospital system for the same care are not uncommon. Vivian Ho, an economics professor at Rice University, found at Memorial Regional in Hollywood, colonoscopies range from $550 to $6,400 depending on the insurer. Advocates also recommend printing out pricing information available on a hospital website, if available, and bringing it with you during registration. Ungs said with research and persistence, Floridians can make price transparency work for them. To dispute a bill, he suggests getting the list of Florida hospitals that are noncompliant from 'If a provider is non-compliant, that can be a reason to dispute the bill,' he said. A provision of a Florida law that went into effect last year requires hospitals to have an internal grievance process for patients to dispute charges. 'Patients need to stick up for themselves,' he said. 'Don't give hospitals a pass because they are using complex billing systems that they choose to use.' He recommends writing a letter to the hospital, and continuing to write to the hospital until you get a result. 'Perseverance is a big factor in success with this,' he said. 'Patients have to stick with it. Those who do tend to get action.' South Florida Sun Sentinel health writer Cindy Goodman can be reached at cgoodman@ or at 954-304-5908.
Malaysian Reserve
20-05-2025
- Health
- Malaysian Reserve
PatientRightsAdvocate.org Calls on Gov. Stitt to Swiftly Sign Hospital Price Transparency Legislation
OKLAHOMA CITY, May 20, 2025 /PRNewswire/ — (PRA) applauded today's bipartisan passage by the Oklahoma Legislature of major legislation to deliver hospital price transparency for Oklahomans and urged Governor Kevin Stitt to sign the bill without delay. If enacted, Senate Bill 889 would require Oklahoma hospitals to post the exact prices of available services online for upfront public viewing, with mechanisms included for state enforcement and patient protection. 'The passage of S.B. 889 is a victory for every healthcare consumer in Oklahoma,' said PRA Founder and Chairman Cynthia Fisher. 'The ability to see and compare hospital prices in exact dollars and cents will empower patients to shop for the best care at the lowest price, and spur unprecedented competition in a functional market. Oklahomans will have more protection than ever from hospital overcharges and surprise bills. Real prices will increase accountability, lower costs, improve care, and save lives. Especially as Oklahoma struggles with the second-highest medical debt rate in the nation, we applaud sponsors Rep. Lepak and Sen. Murdock for delivering new hope to their state, along with each legislator who supported this historic bill. We encourage Governor Stitt to sign this transformative legislation into law as soon as possible.' SB 889 would codify the federal Hospital Price Transparency Rule first enacted in January 2021 under President Donald J. Trump and since expanded in February 2025. 'Today's good news in Oklahoma is part of a much larger movement across America that is determined to revolutionize the healthcare system with radical price transparency,' added Fisher. 'Across the country, elected leaders are taking bold action to put power in the hands of their constituents with upfront prices. We don't expect the momentum to slow down, and we surely won't let it.' According to PRA's Seventh Semi-Annual Hospital Price Transparency Report, only 12% of Oklahoma hospitals reviewed are fully complying with the federal rule. Of the 2,000 hospitals reviewed nationwide, just 21% were found to be in full compliance. About PRA (PRA) is a leading national healthcare price transparency organization dedicated to ushering in systemwide transparency through advocacy, testimony, media, legal research, and grassroots campaigns. PRA believes that the availability and visibility of actual, upfront healthcare prices will greatly lower costs for patients and employers through a functional, competitive healthcare marketplace.
Yahoo
20-05-2025
- Health
- Yahoo
PatientRightsAdvocate.org Calls on Gov. Stitt to Swiftly Sign Hospital Price Transparency Legislation
OKLAHOMA CITY, May 20, 2025 /PRNewswire/ -- (PRA) applauded today's bipartisan passage by the Oklahoma Legislature of major legislation to deliver hospital price transparency for Oklahomans and urged Governor Kevin Stitt to sign the bill without delay. If enacted, Senate Bill 889 would require Oklahoma hospitals to post the exact prices of available services online for upfront public viewing, with mechanisms included for state enforcement and patient protection. "The passage of S.B. 889 is a victory for every healthcare consumer in Oklahoma," said PRA Founder and Chairman Cynthia Fisher. "The ability to see and compare hospital prices in exact dollars and cents will empower patients to shop for the best care at the lowest price, and spur unprecedented competition in a functional market. Oklahomans will have more protection than ever from hospital overcharges and surprise bills. Real prices will increase accountability, lower costs, improve care, and save lives. Especially as Oklahoma struggles with the second-highest medical debt rate in the nation, we applaud sponsors Rep. Lepak and Sen. Murdock for delivering new hope to their state, along with each legislator who supported this historic bill. We encourage Governor Stitt to sign this transformative legislation into law as soon as possible." SB 889 would codify the federal Hospital Price Transparency Rule first enacted in January 2021 under President Donald J. Trump and since expanded in February 2025. "Today's good news in Oklahoma is part of a much larger movement across America that is determined to revolutionize the healthcare system with radical price transparency," added Fisher. "Across the country, elected leaders are taking bold action to put power in the hands of their constituents with upfront prices. We don't expect the momentum to slow down, and we surely won't let it." According to PRA's Seventh Semi-Annual Hospital Price Transparency Report, only 12% of Oklahoma hospitals reviewed are fully complying with the federal rule. Of the 2,000 hospitals reviewed nationwide, just 21% were found to be in full compliance. About PRA (PRA) is a leading national healthcare price transparency organization dedicated to ushering in systemwide transparency through advocacy, testimony, media, legal research, and grassroots campaigns. PRA believes that the availability and visibility of actual, upfront healthcare prices will greatly lower costs for patients and employers through a functional, competitive healthcare marketplace. View original content to download multimedia: SOURCE Patient Rights Advocate Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
12-05-2025
- Health
- Yahoo
PatientRightsAdvocate.org Launches New York City Hospital Price Finder
New York City patients empowered to compare prices, save on care, fight surprise bills NEW YORK, May 12, 2025 /PRNewswire/ -- Today, (PRA) announced the New York City Hospital Price Finder Tool, empowering all who are treated in New York City hospitals with free access to all available prices so they can compare, prevent overcharges, and have recourse for surprise bills. Patients, employers, unions, and researchers in New York City are now able to search all posted prices by hospital, procedure, plan, and code at "The New York City Hospital Price Finder Tool is a huge step for New York City healthcare consumers, who have long suffered from hidden healthcare prices, kept secret by hospitals and insurers alike," said Cynthia Fisher, Founder and Chairman of PRA. "This tool will enable patients to easily compare actual prices, including discounted cash rates, and choose the best care at a price they can afford. Now, patients will have financial certainty as well as safeguards when their bill doesn't match the price, to protect them from overcharges." In December 2022, New York City Council Member Julie Menin sponsored Intro. 844-A to establish the nation's first Office of Health Care Accountability to equip New Yorkers with the upfront pricing information needed for healthcare decisions. In June 2023, the legislation passed unanimously and was signed into law. "New Yorkers will no longer live in fear that medical care will put them in financial ruin. Following our work to establish the Office of Health Care Accountability, this tool is the next step to provide New Yorkers with the resources needed to find the highest quality of care at the best price," said New York City Council Member Julie Menin. "Now, patients can easily research ahead of medical decisions with peace of mind that New York City will enforce price transparency to safeguard their physical and financial well-being." For many patients, this tool would have made an enormous difference. The Singh family of New York City is speaking out on the value of this service. "With upfront and real prices, we would have been able to make an informed decision on how best to proceed with our son's treatments to best help his physical health and our family's financial health. If we had been able to compare in advance, we would have been willing to drive a little further, or perhaps even had a better option nearby, to avoid the tremendous debt that has burdened our family throughout an incredibly vulnerable time," said Shameeza Singh. "We hope this tool will be a powerful resource for every patient in New York City so that devastating medical debt stories are no more and families can instead fully focus on treatment and recovery." The first of its kind in New York City, PRA recently introduced a similar tool in Colorado and has plans to continue expanding resources for patients across the country. "Healthcare price transparency will deliver high quality care at lower costs for patients, but that starts with easy access to prices. The New York City Hospital Price Finder will allow New Yorkers to quickly compare healthcare prices across the city," said Manny Pastreich, President of 32BJ SEIU. "We need real transparency and accountability to make informed decisions and lower costs, and this resource is a strong step in that direction." View more photos here. View Council Member Menin's remarks here. (PRA) is a leading national healthcare price transparency organization dedicated to ushering in systemwide transparency through advocacy, testimony, media, legal research, and grassroots campaigns. PRA believes that the availability and visibility of actual, upfront healthcare prices will greatly lower costs for patients and employers through a functional, competitive healthcare marketplace. View original content to download multimedia: SOURCE Patient Rights Advocate
