As the health care debate continues, health insurers have come under fire for their role in the rising cost of health care. A new study from America's Health Insurance Plans (AHIP) is pointing the finger at health care providers.

The report, prepared by Dyckman & Associates, claims that some physicians who choose not to participate in health insurance networks are charging patients fees that are much higher than Medicare reimbursement for the same service in the same geographic area. For example, the report cites a physician billing a patient $6,791 for “cataract surgery with insertion of artificial lens”—more than 1100% of the Medicare fee of $581.  

“As policymakers pursue health care reform, we encourage them to look at how much is being charged for services, particularly since higher charges don’t mean high quality of care,” said AHIP president and CEO Karen Ignagni said in a statement. “With the nation facing the crushing burden of rising medical costs, all stakeholders should be focusing on constructive ways to bring costs under control.”

AHIP says that similar examples were found in all 30 states where the study was conducted.


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