Judith Waltz Quoted on Hospital Provider Relief Fund Balance Billing Noncompliance

Foley & Lardner LLP partner Judith Waltz addressed potential hospital noncompliance with the balance billing requirement of the provider relief fund in the Report on Medicare Compliance article, “Hospitals May Have to Return Money to Patients From PRF Balance Billing.”

A recent report from the U.S. Department of Health and Human Services Office of Inspector General details that some hospitals did not fully comply with the PRF’s balance billing requirements during the COVID-19 public health emergency. Waltz explained that hospitals that failed to meet these requirements may now be ordered by the Health Resources and Services Administration to repay patients who were overcharged for COVID-19 services.

Waltz noted that “repaying patients may be an uphill battle,” as locating affected individuals and recalculating charges are obstacles that will require significant manual effort to resolve.

Of the report’s findings overall, Waltz said that for the most part, hospital errors likely reflect “sloppiness in a very chaotic time,” rather than intentional fraud. She cautioned though that additional false claims lawsuits may arise from noncompliance with PRF terms and conditions.