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Patient Disputes Mark Up In Medication

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Sep 25, 2009 3:27 pm US/Mountain

Patient Disputes Mark Up In Medication

Written for the Web by CBS4 Special Projects Producer Libby Smith

Reporting
Karen Leigh
LITTLETON, Colo. (CBS4) ― Jim Bujalski spent one night in the hospital and got a bill for more than $58,000.

"I was surprised at the amount of the bill," Bujalski told CBS4.

Medicare and supplemental insurance covered most of the costs, but there was still a bill of $730. Charges for what the hospital calls "self-administered drugs" - drugs that Bujalski takes regularly at home.

"What I found out is that $730 plus a few pennies normally cost me under $30," Buljalski said.

He did a cost comparison. St. Anthony's Central charged him about $497 for two tablets of Plavix, a drug Buljalski usually pays 8 dollars for. A Crestor tablet cost $65 in the hospital, at home he pays about $3 for it.

"I thought there's got to be some mistake here," Buljalski said.

St. Anthony's Central issued a statement saying, " Upon receiving billing complaints, it is our policy to audit the bill and respond to the patient with any needed adjustments or corrections."

In fact, they did offer Buljalski a 40-percent discount on his bill that would bring it down to $438.

"That's still unreasonable to me," Buljalski explained.

In the same letter, St. Anthony's Central's parent company, Centura Health explained the price difference as the cost of "providing a high level of care to all of our patients" saying "services are much more expensive than a physician's office".

That still doesn't help Buljalski understand a 3,495-percent mark-up on his medications.

"I don't understand how they can come anywhere close to justifying that."

During a Beating the Recession Town Hall Meeting on healthcare, a panel of experts took on this billing issue.

"They always talk about how much an item costs on the bill and they compare it to what's available on the retail. Unfortunately what goes into all of those charges that are there are all the costs that the individual doesn't see, but is the capacity of the hospital ready to serve. It's not a matter of just what that bill costs and what it costs to provide medical care in the totality," said Steve Summer, president of the Colorado Hospital Association.

"The insurance company will help you audit your bill and go through it line-by-line to make sure that your bill is understandable and the charges are correct," said CBS4 Medical Editor, Dr. Dave Hnida.

"Anybody who has a charge on a bill had a line item on a bill that has a question that's what we're there for, the hospital is ready to sit down and wants to explain it," Summer added.

(© MMX CBS Television Stations, Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

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