Some hospitals require insured patients to make larger upfront payments for elective procedures, surgeries

The South Florida Sun-Sentinel on Tuesday examined how across the U.S., "some insured patients are being asked by hospitals to pay larger portions of their bills upfront -- and sometimes hospitals will not do the procedures until they get their copayments."

Although hospitals must provide emergency treatment without receiving upfront payment, elective or scheduled procedures, such as angioplasty or chemotherapy, "can be withheld depending on a patient's ability to pay," according to the Sun-Sentinel.

A voluntary survey conducted by the Internal Revenue Service in 2006 found that 14% of 481 not-for-profit hospitals nationwide required an upfront payment or payment plan before a patient was admitted. Hospitals maintain that the slow economy and rising health care costs have resulted in many unpaid medical bills and the practice is needed to offset such costs. However, patient advocates contend that requiring payment before services are delivered can cause stress on already vulnerable patients who might have life-threatening illnesses.

Hospital officials in Florida say that patients are being asked to pay larger amounts upfront as insurance companies require patients to make higher out-of-pocket contributions to their care. David Smith, CFO for Memorial Regional Hospital in Florida, said, "As the economy worsens, employers are having a harder time affording insurance for their employees, they're increasing the patient portions, and patients' benefits actually decrease" (Torbati, South Florida Sun-Sentinel, 8/26).