To the editor:
The long letter about medical insurance billing is partially correct.
If a provider charges a private pay patient a fee close to what the health insurance carrier would pay the provider for an insured patient, the insurer considers that a discount that they should also get.
If a carrier determines this has happened, they can and do go back several years and demand refunds from the provider — that's the punishment.
How would the carrier know? They can and do detailed audits of the provider's records, especially the billings.
The government has nothing to do with this unless the letter writer is referring to elected officials that decades ago gave health insurance companies an exemption from the Sherman antitrust act.

Bob Burns