April 03, 2020

Castro Urges HASC to Overhaul Emergency Billing Practices at Brooke Army Medical Center

WASHINGTON—Congressman Joaquin Castro (TX-20), Chairman of the Congressional Hispanic Caucus, Vice Chairman of the House Foreign Affairs Committee, Chairman of the House Foreign Affairs Subcommittee on Oversight and Investigations, and member of the House Intelligence and Education and Labor Committees, today released the following statement after urging the House Armed Services Committee to consider reforming the billing practices of Brooke Army Medical Center (BAMC) when care is provided to civilians in emergency situations, as HASC begins to develop the National Defense Authorization Act for Fiscal Year 2021:

“The time has come for military hospitals treating civilians to reform their billing practices. I have constituents who were provided emergency trauma care at Brooke Army Medical Center who were suddenly burdened by outrageous surprise medical bills despite having health insurance. For uninsured constituents – 17.7% of our entire state – instead of receiving a balance bill, BAMC sends them a crippling bill for the entire cost of care. In both circumstances, these are federal debts that BAMC under federal law must turn over to the Treasury Department for collection, financially devastating lives in the process. I am urging the House Armed Services Committee to put an end to surprise billing for those with insurance and drastically reform its billing practices for the uninsured. States across the country have banned the practice of balance bills and Congress is expected to enact a federal ban later this year, but these laws do not apply to military hospitals. This must change. No one should face financial ruin because of a surprise medical bill.” 

Background: BAMC, the only Level I Trauma Center in the Department of Defense (DoD), is fully integrated into San Antonio’s civilian trauma and emergency healthcare system. Within this 22-county trauma service area, BAMC is one of only two Level I trauma centers, meaning civilian trauma patients in need of the highest level of surgical care are often sent there. The most recent statistics available show that BAMC served more than 4,000 trauma patients in the last year, 85 percent of whom were civilians. 

Despite all the unique benefits this trauma center provides to Texas patients and our military, BAMC’s billing practices warrant closer examination and reform. San Antonians covered by private health insurance too often receive surprise medical bills from BAMC through a process called balance billing. In these cases, BAMC bills the patient for charges that exceed the patient’s health insurance plan’s payment for a covered service. Many states in recent years have enacted laws forbidding the practice, including the state of Texas. Congress is also expected to pass a federal balance billing ban in the 116thCongress. 

For uninsured patients, instead of receiving a balance bill, they are sent a bill for the entire cost of service. For example, one of my constituents received a more than $150,000 bill after BAMC repaired a ruptured bladder resulting from a car crash.

To read the full text of the letter, click here.

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