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NewslettersBrainstorm Health

Congress Is Investigating Private Equity’s Role in Huge Medical Bills: Brainstorm Health

By
Sy Mukherjee
Sy Mukherjee
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By
Sy Mukherjee
Sy Mukherjee
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September 17, 2019, 5:38 PM ET

Here’s a thing that happens in the world of American health care: You can show up to a hospital, have insurance, and then still unexpectedly be charged a bunch of money (potentially in the tens of thousands, if not significantly more) well after you’ve left the facilities.

This “surprise billing” practice isn’t a new phenomenon. It can occur, for example, if a patient goes to a hospital that’s within their insurance network but are treated by a doctor who isn’t. Given the disparate forces of the U.S. health system, this is the kind of situation that’s pretty hard to suss out—especially when you consider third party ambulances, doctors who aren’t within your network, or the basic reality that you can’t exactly choose which hospital or provider you go to you when you’re medically incapacitated.

The issue is coming to the forefront. And a number of prominent private equity firms—including KKR, Blackstone, and others—are about to face Congressional scrutiny over their potential roles in surprise medial billing.

House Energy and Commerce Committee Chairman Frank Pallone and ranking member Greg Walden (a bipartisan duo) are leading the charge.

Here’s what they had to say to the private equity firms of interest in a statement:

“We write to request information regarding… ownership, policies, and practices as it relates to third-party medical providers. We are particularly interested in your firm’s relationship with any physician staffing companies and emergency transportation companies,” they wrote.  

“In recent years, the Committee has heard countless heart-wrenching stories from insured individuals who have received thousands of dollars in medical bills after inadvertently receiving care from out-of-network providers.”

A Blackstone spokesperson responded in an emailed statement: “Blackstone’s portfolio company TeamHealth fully supports legislation to end surprise medical bills through an approach called independent arbitration that has proven successful in New York and Texas. TeamHealth also has a long-standing policy against balance billing its patients. We look forward to responding to this letter and outlining the company’s approach.”

Much more on this soon. Read on for the day’s news.

Updated to include a statement from Blackstone.

Sy Mukherjee, @the_sy_guy, sayak.mukherjee@fortune.com

DIGITAL HEALTH

The CRISPR patent war rages on. The University of California, Berkeley is touting a new patent win in the CRISPR gene editing wars. The university says its total CRISPR patent portfolio is up to 12. (As readers know, Berkeley and the Broad Institute of Harvard and MIT have been engaged in a tough, and sometime ugly, dispute over who owns the intellectual property.)

INDICATIONS

Former FDA commish joins another pharma board. Former FDA commissioner Scott Gottlieb was pretty deep into the biopharma world before he took the reins at the FDA. He appears to be getting right back into the swing of things after his departure earlier this year. Now, Gottlieb is joining the board of health data startup Aetion in, what he says, is an effort boost companies that leverage "real world evidence" in the health care arena. (FiercePharma)

THE BIG PICTURE

Juul sales halted in China. Mere days after a proposed launch, Reuters reports that Juul's e-cigarette products aren't currently available on e-commerce sites in the country. It's unclear whether or not this has anything to do with the recent proposed crackdowns on the vaping industry in the U.S.—but China is the single largest market for smokers in the entire world. (Reuters)

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