LV legislator seeks investigation of UMC billing practices

Thursday, Feb. 22, 2001 | 9:46 a.m.

CARSON CITY -- A Las Vegas assemblyman has called for an audit of University Medical Center to determine if the public hospital was improperly collecting payments from patients whose accounts should have been closed.

Assemblyman Doug Bache, D-Las Vegas, is concerned about what he alleges is a practice at the hospital to routinely charge patients over and above what is stipulated in the contract the hospital has with the patients' insurers.

Bache told the Assembly Health and Human Services Committee Wednesday that it happened to him and that he has been told there are numerous instances of such billing practices.

But Bob Badal, director of managed care for UMC, said that while there are mistakes, this is not a widespread practice. And he said some patients don't understand that their insurance does not cover all services.

Assemblywoman Ellen Koivisto, D-Las Vegas, who chairs the committee, said there were lots of unanswered questions about Assembly Bill 52 and referred it to a subcommittee headed by Assemblywoman Debbie Smith, D-Sparks.

Bache said his personal case occurred last year when he took his child to a UMC quick-care facility. He said he met his co-payments and deductible but then received a bill for $68. He said he became suspicious because he had just read an article in the Sun about this type of billing.

Bache is covered by an insurance policy handled by the Clark County Teachers Association, and he took the bill to that office. The union, he said, has a contract with UMC to pay a certain amount for each procedure. And the hospital, he said, is supposed to absorb the difference between the contracted price and what the procedure would have cost without such a contract.

He said he was told by union officials that they get 25 cases a week of UMC trying to collect the excess payments.

Badal denied Bache's claim about 25 cases a week occurring with the teachers union insurance. He said he has letters from insurance carriers stating that UMC's claims processing abides by the contract.