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Hospitals Marking Up Cancer Treatments, Medicare Records Show

Individuals receiving outpatient services for cancer treatments, such as chemotherapy or radiation, are more likely to be billed as much as six times what Medicare will cover, according to an analysis conducted by a cancer surgeon.

Dr. Martin Makary, a professor of health policy at the Johns Hopkins University School of Medicine, studied hospital records from more than 3,400 facilities across all 50 states.

On average, hospitals marked up the costs of cancer-related treatments by between 2.4 and 4.1 times what Medicare would cover. So, if Medicare would offer a $1,000 reimbursement for a procedure, hospitals are charging patients between $2,400 and $4,100, on average.

“Cancer patients shouldn’t be put into household bankruptcy just because a hospital inflates a bill well above what an insurance company would pay for the exact same service,” Makary said.”Unwarranted price markups contribute to the skyrocketing cost of health insurance and out-of-pocket costs to patients. We found some cancer centers bill fairly while others engage in outright price gouging of insurers, patients and their employers. Hospital differences in quality or charity care do not account for these dramatic price differences.”

From the study: radiology departments treating cancer patients charged an excess of 3.7 times more for services; hematology/oncology 2.3 times more; medical oncology 2.4 times more; pathology 4.1 more; and radiation oncology 3.6 times more.

Researchers are calling for standard pricing legislation, to reduce the financial burden of cancer patients.

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