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On Friday, March 27, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security Act\u2014otherwise known as CARES. This CARES Act covers the whole $2 trillion megillah stimulus package, but in this health care podcast episode, we\u2019re talking quickly about a provision in that Act.

I speak first with Doug Aldeen, an attorney specializing in helping employers settle hospital bills. Doug works with clients across the country. And then at the end of the episode, you will also hear from Al Lewis, who is a founder over at Quizzify. Al Lewis, as many of you may or may not know\u2014but if you don\u2019t know, you should\u2014created a \u201csurprise billing wallet card\u201d that is actually super relevant to this discussion as you will see. There\u2019s actually going to be a whole surprise billing episode coming up soon where we discuss this wallet card, so you can consider Al\u2019s short commentary today as kind of a coming attraction.

The provision that we\u2019re going to talk about in this episode is the No Cost Sharing for COVID-19 Testing and Vaccines provision. This is where insurers are required to cover testing for COVID-19 without cost sharing to their enrollees, and they must pay for the tests based on contracts or the posted pricing of labs. So, the thing is, hospitals and diagnostic testing companies can essentially basically name their price on COVID-19 tests; and employers and insurers will be required to pay for it. This is in Section 3202, the Price of Diagnostic Testing, in that CARES Act.

The plot thickens this week as health insurers\u2014including Aetna, Cigna, and Humana\u2014are now waiving patient cost sharing on all treatment for coronavirus, not just the testing, including hospitalizations and ambulance transfers. And they\u2019re doing this for their insured members and employer plans at their in-network health systems\u2014emphasis intended on the \u201cin-network\u201d part.

So, you might be thinking, \u201cGreat \u2026 no costs to anybody!\u201d But I did emphasize that last part for a reason. If you think for a minute about this, just because patients are not paying co-pays for COVID treatments first of all doesn\u2019t mean that while they\u2019re in the hospital that their diabetes won\u2019t flare up \u2026 or their MS or their RA. COVID-19 is just one thing, and the US has a patient population that has, let\u2019s just say, no shortage of chronic conditions\u2014otherwise known as underlying conditions, otherwise known as the people most likely to be in the ICU.

My concern is that there\u2019s nothing to say that co-pays and coinsurance for treatment of other things while being treated for COVID are going to suddenly vanish, too, even if it\u2019s an in-network health system. Furthermore, there is that problem of a patient going to a hospital that\u2019s not contracted with the employer plan or the patient\u2019s insurance carrier. At that point, I\u2019m not seeing anything that would suggest that patients with COVID-19 are going to get any different treatment billing-wise than patients with anything else.

We\u2019ve seen COVID-19 bills that are, for uninsured patients, $34,000 and $73,000 in the press. What if the patient doesn\u2019t have out-of-network coverage, for example? What if the patient\u2019s out-of-network deductible is tens of thousands of dollars like some of them are? I don\u2019t see anything in this bill to suggest that those are suddenly going to go away. And, oh, by the way, exactly as the bill pretty much states explicitly, regardless of what the patient pays, the employer\u2019s on the hook to pay for whatever the hospital chooses to charge\u2014at least as far as testing goes.

Doug Aldeen is an Austin, Texas\u2013based health care and Employee Retirement Income Security Act (ERISA) attorney who recently served as ERISA counsel on behalf of the Berkeley Research Group in New York City to the $7.7 billion May 2016 acquisition of Multiplan and its medical bill repricing product Data iSight by the private equity firm Hellman and Friedman. Since 1997, he has represented reference base pricing organizations, a bundled payment software platform, PPO networks, medium to small self-funded plans, third-party administrators, and provider-sponsored health maintenance organizations in various capacities, including Herdrich v. Pegram, which was argued before the US Supreme Court in 2001. Moreover, he serves as a resource to national news organizations regarding issues on health care and as a consultant with the Governmental Relations Committee at the Self-Insurance Institute of America in Washington, DC, and as an adviser to RIP Medical Debt, which has abolished over $1.2 billion in medical debt. Doug received his JD from the University of Illinois.

Al Lewis wears multiple hats, both professionally and also to cover his bald spot.

Hat #1: Employee Health Literacy. He is the founder and \u201cquizmeister-in-chief\u201d of Quizzify, whose mission is to help companies teach their employees to utilize healthcare services appropriately, using a format best described as \u201cJeopardy meets health benefit education meets Comedy Central.\u201d Quizzify is the only vendor authorized to display the Harvard Medical School \u201cVeritas\u201d shield and has received excellent reviews from users.\xa0

Quizzify is best known today for its employee coronaquizzes (now exceeding 100,000 plays!) and its surprise billing \u201cPrevent Consent\u201d solution, which was recently featured in the New York Times. It can be taped to an insurance card, used as a stand-alone card, or downloaded into your Apple Wallet.

His quiz-specific background includes authorship of the best-selling Newsweek Presents the Ultimate Trivia Game, which Games magazine lauded as having the best questions of any trivia game; hosting two quiz shows on Boston network affiliates; and appearing on Jeopardy.

Hat #2: Outcomes Measurement. As an author, his critically acclaimed category best-selling book on outcomes measurement, Why Nobody Believes the Numbers, chronicling and exposing the innumeracy of the health management field, was named digital health book of the year in Forbes. Cracking Health Costs, written in conjunction with Walmart alum Tom Emerick, was also a trade best seller. Surviving Workplace Wellness has also received great accolades, and excerpts appeared in Harvard Business Review and elsewhere.\xa0

He was the cofounder of the World Health Care Congress\u2019s Validation Institute.\xa0

His expertise in outcomes measurement got him named one of the unsung heroes changing health care forever.\xa0

He graduated Phi Beta Kappa with honors from Harvard, where he taught economics as well. He also graduated from Harvard Law School, albeit with no honors that time\u2014other than winning their annual trivia contest, of course.

04:12 Hospital billing as it relates to COVID-19.
05:45 Who is \u201con the hook\u201d for paying these COVID-19 bills.
08:17 \u201cReasonable payment\u201d in the case of COVID-19.
08:45 Is COVID-19 different than every other billing situation?
10:12 What\u2019s going to come out of the out-of-network COVID-19 costs?
11:29 What employers should be doing right now.
12:50 The takeaway for everyone \u201cbankrolling\u201d COVID-19.
13:26 \u201cThis whole thing is tilting towards, \u2018Who\u2019s going to pay for all this stuff?\u2019\u201d
13:53 Connecting the dots with COVID-19 billing.
15:25 Using the Quizzify wallet card, and how this can help avoid COVID-19 surprise billing.
16:17 Download the wallet card at quizzify.com.\xa0

Check out our newest #AnExpertExplains #healthcarepodcast with @AldeenDoug and @whynobodybeliev of @quizzify as they discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling

Who is on the hook for #coronavirus billing? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

What is #reasonablepayment in the age of #coronavirus? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

Is billing for #coronavirus different than all other billing? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

What\u2019s going to come out of the out-of-network COVID-19 costs? @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

\u201cThis whole thing is tilting towards, \u2018Who\u2019s going to pay for all this stuff?\u2019\u201d @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast

Connecting the dots with #covid19billing. @AldeenDoug and @whynobodybeliev of @quizzify discuss #hospitalbilling in the age of #covid19. #healthcare #podcast #digitalhealth #billing #healthcarebilling #healthcarepodcast