Doctors Must Pay for Privilege of Getting Paid

For those who complain that doctors have a knack for coming up with inventive fees, ProPublica has a shoe-on-the-other-foot narrative that illustrates the shady nature of the healthcare billing industry. It seems that most doctors have to pay a fee for the privilege of getting paid. These days, when insurers issue payments to doctors for services rendered, they usually do so electronically instead of, say, by writing a check. The problem is that insurers routinely charge a fee of up to 5% for this convenience, according to the story, and the costs add up. Larger medical practices have to shell out about $1 million a year, while smaller practices might pay $100,000. In the latter case, that means the practice has to use that money to pay processing fees instead of perhaps hiring a registered nurse to better help patients.

"It's ridiculous," says Karen Jackson, who was a senior official at a federal agency called the Centers for Medicare & Medicaid Services until retiring earlier this year. The CMS has the power to do away with such fees, and it actually did so in 2017. However, that decision was quickly and quietly reversed, and the story digs into how that happened. One key figure is a powerful lobbyist named Matthew Albright, who once worked for the CMS. He now represents "the industry he previously regulated," and the story suggests he still holds great sway within the federal agency. It's not just insurers presented as the root of the problem—it's a whole new industry of payment processors looking to take their cut when money changes hands. Read the full story. (Or check out other longform stories.)