Medical instrument cases are the most common type of tuberculosis in the United States, accounting for about 5 percent of the overall cases, according to the Centers for Disease Control and Prevention.
While some states require physicians to provide medical instruments during TB patient care, most states do not.
Some doctors are taking advantage of the lack of oversight to charge patients for them, even though such charges would violate TB policy, said John K. Gresko, MD, director of the TB program at New York-Presbyterian/Columbia University Hospital.
In 2015, the American Medical Association urged hospitals to consider charging patients for their medical instruments after finding that patients who are given the charge were more likely to receive antibiotics and receive a TB test.
The American Medical Group, the largest hospital group, told Bloomberg that it would work with health departments to ensure that their policies were not being misused by physicians, though it also cautioned that the AMA’s recommendation was not binding.
The hospitals have had mixed results on charging patients.
In 2016, the National Health Service Board recommended that medical institutions charge patients who receive TB tests for their instruments, but that the measure did not affect TB patient health care.
A new effort by the AMA is to ask hospitals to charge for their devices after the CDC’s guidelines are published in October, the group said in a letter to hospitals in September.
The AMA says that it is not the first time hospitals have charged for TB patients’ medical equipment.
In 2011, the U.S. Centers for Medicare & Medicaid Services (CMS) found that hospitals had charged patients in the U.”s medical-device program for about 1,000 TB cases over a 10-year period.
The U.N. Committee Against Torture has also found that health systems in other countries have been charging patients and staff for TB care.