Issue link: https://beckershealthcare.uberflip.com/i/1242957
10 CFO / FINANCE Woman sued by Alabama hospital over $31K bill: 'I wish you'd have let me die' By Ayla Ellison A n Alabama woman received an emergency appendectomy at Flow- ers Hospital in Dothan, Ala., in May 2016. ree years later, the hospital sued her for nearly $37,000, which included a $31,000 bill plus interest, according to CBS News. KC Roberts didn't have insurance at the time of the emergency surgery in 2016. She and her husband own a struggling T-shirt screen printing company and could no longer af- ford insurance in 2015. Ms. Roberts told CBS News she was shocked when she received a $52,000 bill from Flowers Hospital aer her surgery. Aer applying a discount for uninsured patients, she owed about $31,000. Ms. Roberts and her husband paid $25 per month toward the bill for three years. How- ever, in September 2019 the hospital sued her for the full balance plus interest. "I told my husband, 'I wish you'd have let me die,'" Ms. Roberts told CBS News. "I've said, 'Honey, I love you and I love my family, but if you had let me go, today you would not be going through this.'" In a statement to CBS News, Flowers Hospital said it offers interest free payment plans and makes several attempts to contact patients before pursuing legal action. "It is our strong preference to work directly with patients," the hospital said, according to CBS News. "Unfortunately, some individ- uals refuse to engage with us to resolve their balances. Litigation is always a last resort and is only pursued aer we determine the pa- tient has the financial ability to make some level of payment based on employment status and credit record." n CMS pitches changes to CJR model: 5 things to know By Ayla Ellison C MS issued a proposed rule Feb. 20, which includes a three- year extension of the Comprehensive Care for Joint Replace- ment model. Five things to know: 1. The CJR model, CMS' first mandatory bundled payment initia- tive, began April 1, 2016, and is slated to end Dec. 31, 2020. Under the payment model, acute care hospitals are held accountable for the quality of care they deliver to Medicare beneficiaries for hip and knee replacement from surgery through recovery. 2. The proposed rule would change the definition of episode of care to include outpatient hip and knee replacements. CMS said it is seek- ing to modify the definition to address changes to the inpatient-only list that now allows for total knee and hip replacements to be treated in the outpatient setting. 3. The proposed rule includes changes to the target price calculation used for the CJR model. One proposed change is to use the most recent year of claims data to calculate the target price, instead of the three years of claims data that is currently used. 4. CMS is seeking to make several changes to the CJR model rec- onciliation process, including moving to one reconciliation period, which would be conducted six months after the close of each per- formance year. Currently, the model uses two reconciliation periods, which take place two and 14 months after the close of each perfor- mance year. 5. The proposed rule seeks to extend the CJR model for three years, through Dec. 31, 2023, "to allow time to evaluate the proposed changes," CMS said.n Coronavirus fears enrich some execs By Alia Paavola T he leaders of some healthcare compa- nies defied the stock market wipeout in late February, growing richer instead of losing money, according to Bloomberg. The executives who saw their fortunes rise all lead businesses that could profit from the coronavirus in some way. For example, Moderna CEO Stephane Bancel briefly became a billionaire after the company shipped an experimental coronavirus vaccine for clinical testing in humans in late February. The stock jumped 42 percent Feb. 25, and Mr. Bancel owns 9.2 percent of the company. His stake after the jump was worth $790 million and his net worth grew $250 million the week of March 2, according to Bloomberg. In addition, Regeneron Pharmaceuticals is working to develop a coronavirus treatment. Its stock gained 10 percent in late February, which added $45 million to the fortune of George Yancopoulos, chief scientist at the pharmaceutical company. Malaysia's Lim Wee Chai, who owns a con- trolling stake in Top Glove Corp., the world's largest maker of medical gloves, also saw his net worth grow from the pandemic fears. His net worth reached $1 billion shortly after the virus began to emerge as a threat, according to Bloomberg. n