Congressional Committee Targets Private Equity Firms On Medical Billing Practices

Author:Mr Brian Ronholm, David Hoffmeister, Georgia Ravitz and James Ravitz
Profession:Wilson Sonsini Goodrich & Rosati

Pointing to an increasing trend of private equity firms acquiring physician staffing companies and private emergency transportation companies contracting with hospitals, a key congressional committee announced a bipartisan investigation this week into the practices of private equity firms related to surprise billing.

In letters to KKR & Co., Inc., Blackstone Group, and Welsh, Carson, Anderson, & Stowe, House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) and Ranking Member Greg Walden (R-OR) requested information and documents pertaining to the firms' ownership of private physician staffing and emergency transportation companies. The letters noted that recent research has demonstrated that these third-party medical providers are the leading sources of surprise medical billing.

"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," the committee leaders asserted in the letters.

Reps. Pallone and Walden also referenced recent findings from the American Enterprise Institute and the Brookings Institution indicating that surprise bills are frequently associated with services provided by an out-of-network emergency physician or ancillary clinician—such as a radiologist, anesthesiologist, pathologist, hospitalist, or assistant consulting surgeon—at an in-network health facility.

While noting recent press reports on the...

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