Judge Deals Setback For Surprise Billing Rules

Welcome to Thursday’s Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. A Texas judge gave a win to doctors in a lawsuit in the latest twist in the battle over surprise medical billing.

Judge strikes part of surprise billing rules

A federal judge in Texas on Wednesday struck down part of the Biden administration’s regulations protecting patients from getting stuck with “surprise” medical bills when they see the doctor, in a win for doctors who sued to block part of the rules.

The ruling leaves in place the protections for patients against getting bills for thousands of dollars in situations such as going to the emergency room and later finding out one of the doctors was not covered by their insurance.

But it strikes down part of the regulations that govern how much insurers will pay doctors once the patient is taken out of the middle.

The ruling, from Judge Jeremy Kernodle, an appointee of former President Trump, is the latest in a long-running fight over the details of the rules.

The Texas Medical Association, which brought the case in question, is one of several doctor and hospital groups that have sued, arguing the details of the rules would lead to damaging cuts to their payments and benefit insurance companies.

Many experts and consumer groups have defended the Biden administration’s rules, arguing that doctors are simply seeking to protect inflated payments.

Experts warn that if doctors groups get their way, it could lead to higher premiums for consumers once the higher prices are passed on to them.

Kernodle ruled that the Biden administration had departed from the text of the law passed by Congress in 2020 in issuing its regulations.

LA relaxing indoor mask rules

Beginning Friday, various establishments, businesses and venues are permitted to make masking optional for individuals that are fully vaccinated against COVID-19, according to a statement on Wednesday from the county’s public health department. The scaled-back regulations will also apply to fully vaccinated employees.

What the new rules say: Establishments must verify that all customers ages five and older are fully vaccinated against COVID-19 before they enter the indoor space, according to the county.

Customers who present proof of a recent negative COVID-19 test will also be allowed to enter without a mask. If individuals present a PCR test it must be from within two days of entry, and within one day of entry for antigen tests.

Those who are not vaccinated against COVID-19 and do not have proof of a recent negative test must continue to wear a mask indoors.

Black women are overrepresented and underpaid in health

Black women are more overrepresented in health-care jobs than any other demographic groups, and are concentrated in its lowest-paid and most dangerous roles — disparities that are products of structural racism and sexism, according to a new study published this month in the journal Health Affairs.

Black women make up nearly 7 percent of the U.S. labor force, but nearly 14 percent of the health-care workforce, according to the study. Within health care, the study notes, Black women are most likely to work in the long-term care sector, currently making up 23 percent of that labor force, and as licensed practical nurses or aides, constituting 25 percent of those workers. These roles “are characterized by low wages, lack of benefits, and hazardous working conditions,” according to the study.

As co-author Janette Dill, an associate professor in the division of health policy and management at the University of Minnesota, put it: “They are taking care of peoples’ bodies, and feeding them, and bathing them, and taking people to the bathroom — it’s very hard physical labor.”

Shantonia Jackson, a 52-year-old certified nursing assistant at City View Multicare Center in Cicero, Ill., is in charge of caring for anywhere from 30 to 60 residents at a time, she said. As a result, “there’s not enough time in the day” to give all of them the care they deserve, said Jackson, who is Black.

“It’s like nobody is caring for the people. … It’s like I’m a number,” said Jackson, who also serves as a member of the SEIU Healthcare union and an advisory board member to the Center for Equity, a national advocacy organization for long-term care workers.

City View administrators did not respond to requests for comment.

According to Dill, large caseloads like Jackson’s are partly due to a mass exodus of health-care workers from their jobs due to low pay and burnout amid the demands of the coronavirus pandemic.







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