Hedge Fund Maneuvers In The Dark

There always has to be someone at the bottom.  There really is a group that is less trusted than insurance companies, less popular than Congress.   The winners of the “who is our least favorite / least trusted” are the owners and operators of Hedge Funds.   With the exception of Mitt Romney extolling the virtues of Bain Capital, many Americans only contact with a hedge fund or private equity company was when their local factory jobs were eliminated.  Disliking hedge funds isn’t limited to just Democrats or just Republicans.  There are very few truly bipartisan issues in Washington and our local statehouses.   Surprise Medical Billing may be just such an issue and we have some hedge funds to thank for this.

My last post, Step Away From The Wallet, discussed the misleading ads from a group called “Physicians for Fair Coverage”.  The ads, part of a $17 million dollar ad buy, have peaked the interest of the Chairman, Frank Pallone Jr. (D-N.J.) and Ranking Member, Greg Walden (R-OR) of the House Energy and Commerce Committee.  They are initiating an investigation into the three private equity companies that own major physician staffing agencies.

According to The Hill, the two Congressmen are pleased that this issue is totally bipartisan and even has the support of the White House.  Together they have focused their efforts to get more information from KKR, the Blackstone Group, and Welsh, Carson, Anderson & Stowe who own the staffing companies.  Surprise medical billing, especially problematic when the patient has carefully accessed non-emergency care in a network facility only to be seen by a non-network doctor, can result in thousands of dollars of unexpected costs.  It is a gaping hole in our system, the kind that seems perfect for a hedge fund to exploit.

The state legislatures are also looking at this issue.  Some states, like California, are more focused on consumer protection.  Other states may be more interested in maintaining the Status Quo.  Ohio is beginning to look at Surprise Billing.  Ohio SB 198, also bipartisan, had its first hearing this week.  It needs a lot of work and will look a whole lot different (hopefully) if it ever becomes law.  I will link a revised version when it becomes available.

The key today is that transparency in medical billing is an ongoing struggle.  Health insurance is the way most Americans access and pay for health care.  Health insurance companies help to organize the market.  They prove their value every time a patient is balance billed by a doctor employee of a hedge fund.   



Bonus – Orchestral Manoeuvres In The Dark – If You Leave

Picture – Not Another Hedge – David L Cunix

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