Hospitals and Their BUCA Moat Must Go Bye Bye

By Bill Hennessey, M.D.• Chief Innovation & Billing Integrity Officer

Non-profit hospitals have been known to send hate mail to employer groups using reference-based pricing (RBP), meaning a health plan that is not Blue Shield, United, Cigna or Aetna (BUCA). This illegally denies access to care the very working poor entitled to free care under the ACA IRS 501r, dating back to March of 2010.

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