I had to pay $1,463 for a 'pre-payment' before my son got appendix surgery - and no one will tell me why

A Texas mother was shocked to find that doctors would not give her son a surgery to remove his appendix until her husband forked over more than $1,000. 

Dr Emily Porter, a sexual health and wellness physician in Austin, Texas, said that her second-grader developed appendicitis overnight and had to be rushed into emergency surgery.

Despite her son being in critical condition, the hospital required a pre-payment of $1,463.93 without offering an explanation about how administrators arrived at that figure. Typically, Dr Porter’s copay from emergency care is only $250.

The pre-emptive payment demand by the hospital is believed by Dr Porter and others to be a violation of EMTALA. 

This law says anyone who goes to the emergency department must be stabilized by doctors regardless of their insurance status -and then billed after. 

Dr Emily Porter of Austin, Texas, said her husband had no other option but to pay the hospital up front in order to get his son much-needed emergency surgery

Dr Porter said she believes this to be a violation of a federal law that requires emergency departments to stabilize patients regardless of whether they have insurance to foot some or all of the bill

Dr Porter said: ‘How come when you ask what something is going to cost so you can plan/price shop, no one seems to know but somehow they could come up with this on the fly before the surgery ever even happened and without an itemized explanation of benefits?’

She added that she wasn’t the one to take her son to the hospital, her husband was. He was not given an option and, because his child was in need of surgery, did not want to delay the process further and paid the sizeable sum.

Patients without a true emergency who go into the ED are required to pay an up-front fee of $150. 

However, under EMTALA or the Emergency Treatment and Labor Act, hospitals cannot demand payment before stabilizing someone in a medical emergency. And appendicitis is a medical emergency.

Dr Porter said: ‘Seems like an EMTALA violation at worst and tacky as hell to do to a parent of an acutely ill child at best. I think I will raise hell so it doesn’t happen to the next person.’

It is not clear which hospital Dr Porter’s child was admitted to, but there are about 50 in the city.

Hospitals that violate EMTALA run the risk of paying tens of thousands in penalties and even losing their contracts for federal funding

Most hospitals in the country receive some amount of government funding, but some are private and not covered under EMTALA. 

If Dr Porter’s son went to a private hospital, that could explain the charge, though it is far more normal to pay after discharge.

Spending just ONE night here increases your risk of death 

Researchers in France looked at data on patients over the age of 74 from 97 emergency departments around the country between December 12 and 14 in 2022. They compared two groups. 

Violating EMTALA puts government funding in jeopardy.

If the hospital is, in fact, found to have violated the law, it could face financial penalties of up to $100,000 and could open itself up to a civil lawsuit. 

Hospitals violating the law could also lose their Medicare and Medicaid provider agreements.

Last year, the Centers for Medicare and Medicaid Services announced that it was investigating two hospitals for allegedly violating the law after they did not offer necessary stabilizing care to an individual experiencing a medical emergency.

The National Women’s Law Center filed the initial EMTALA complaint on behalf of Mylissa Farmer, named Freeman Hospital West of Joplin, Missouri, and the University of Kansas Health System in Kansas City, Kansas.

The staff there refused to perform a life-saving abortion at 18 weeks despite the risk that Ms Farmer could have contracted an infection, hemorrhaged, and potentially died because that care would have constituted an abortion.

The Biden administration has said repeatedly that EMTALA language includes allowances for an emergency abortion to be performed in the event that the mother’s life is in jeopardy. However, hospitals in many red states hesitate to do them for fear of legal and financial penalties.