Senators chastise doctors who mark up patients’ bills

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By the Lincoln Journal Star

Senators who have been working with doctors, in particular dermatologists and pathologists, on a bill that would prohibit markups on lab test charges spoke just long enough Wednesday morning to admonish the doctors.

Lincoln Sen. Tony Fulton made the opening remarks on the bill (LB1104) that would disallow the markups on charges for anatomic lab tests, such as skin biopsies and Pap smears.

He said testimony at a hearing on the bill confirmed the practice was happening in Nebraska and that the American Medical Association code of ethics was very specific that marking up a lab test that another doctor performed shouldn’t happen.

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Fulton and others, including the Nebraska Medical Association, have been trying for more than a year to come to some sort of compromise with the doctors. Negotiations have gone nowhere.

Fulton had introduced a similar bill last year.

Dermatologists say they believe they should be paid some sort of handling fee for sending a specimen off to a lab, looking over the results and explaining them to patients. Fulton said they could charge a separate handling fee, but the doctors counter that not all insurance companies will pay for that charge.

Insurers, however, say they do compensate doctors for the cost of materials and services when specimens are sent to a lab. Fulton had information that showed both Blue Cross and Blue Shield and Aetna insurance companies do so.

It was Sen. Joel Johnson of Kearney, a retired surgeon and chairman of the Legislature’s Health and Human Services Committee, who leveled the most serious charges about the conflict between the doctors.

“This is a sad day for me,” Johnson said.

He is proud of his profession, but can’t be proud of these doctors’ actions, he said.

At the close of last year’s hearing on the anti-markup bill, he said, committee member Dave Pankonin of Louisville told him he had much less respect for the medical profession.

“If last year’s hearing was bad, this year’s was worse,” Johnson said.

Doctors were insulting each other and accusing each other of unethical behavior, he said. They said it wasn’t about money, he said, but it was about money.

Johnson said lobbyists involved in the issue were handling the issue professionally.

“I wish the people they represented could be so professional,” he said. “This is a serious issue.”

He suggested that both sides remember: Do what’s right for the patient and everything else takes care of itself.

“This bill does not deserve the dignity of these hallowed walls,” he said. “Perhaps a trip to the woodshed would be more appropriate.”

After the senators had their say, Fulton pulled the bill from debate. It will die at the end of the session.

Negotiations will continue, Fulton said, but he and Johnson wanted the doctors to know the Legislature is serious about the issue.

“Here is the bottom line,” he said. “Markups shouldn’t occur.”

Reach JoAnne Young at 473-7228 or jyoung@journalstar.com.