Fraudulent hospital charges I: Medical swag

Elisabeth Rosenthal—former emergency room doctor and current journalist—is my favorite hospital basher. Her husband was recently in a bicycle accident and suffered broken ribs, finger, collarbone, shoulder blade and a collapsed lung. As she says, “the treatment he got via paramedics and in the emergency room and intensive care unit were great. The troubles began, as I knew they would, when the bills started arriving.” She was prepared for the outrageous costs, such as $20 for a pill that costs pennies at a pharmacy. “What I’m talking about here,” she says, “were the bills for things that simply didn’t happen, or only kind-of, sort-of happened, or were mislabeled as things they were not, or were so nebulously defined that I couldn’t figure out what we might be paying for.” Though the charges were technically legal, she calls them, fraudulent. Here is part one of her complaints.

In the trauma bay, someone slapped a plastic brace around her husband’s neck until scans confirmed that he had not suffered a spinal injury. It was removed within an hour. The company that provided the brace billed $319 for the piece of plastic. Their insurer paid $215. (On Amazon, they are about $15.)

Insurers allow companies to bill them for the stuff--what Rosenthal calls "swag"-- that you get for home use, such as slings. But the same sling you can buy at Walgreens for $15 is billed to the insurance company at $120. Apparently, the practice of handing out such medical “swag,” such as slings, braces, and wheelchairs, has led to widespread abuse, with patients sent home with equipment they don’t need. (Rosenthal and her husband didn’t take the brace home, even though they’d paid for it.)

In my own case, after a visit to the emergency as the result of a fall (the chair I was standing on tipped over; I hit the ground on my hip and elbow) I was sent home with a cane, even though I was basically fine (nothing broken). I have no idea what the insurance company paid for it. I kind of like having the cane, though. By holding the tip end, I can reach the levers that open and close the windows over the washing machine and use the handle to grab the levers and raise them up or down. Also, because it’s adjustable, I can make it short and use it to lift myself up from the low stool I sit on when weeding. I’m not sure I could think of anything to do with a neck brace.

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