Despite these warnings, hospitals continued to send accounts to collections. Ferguson sued two other Washington hospitals for violating Washington`s consumer protection law by denying low-income patients access to charitable care. After treatment, Providence-affiliated hospitals are also failing to inform patients they know are eligible for charitable care, the lawsuit says. Ferguson`s lawsuit, filed in King County Superior Court, alleges that these hospitals committed thousands of violations of consumer protection law, including: Between September 2019 and September 2021, hospitals sent 46,783 patient accounts with incomes between 151 and 200 percent of the federal poverty line to debt collection agencies. Together, these accounts had outstanding balances of $53 million. They continue this practice to this day. When hospitals stopped letting insured patients use the tool, they sent an additional 8,454 accounts of currently enrolled Medicaid patients to collection agencies, totaling $20.3 million in patient costs of $20.3 million. Until September 2019, hospitals managed all defaulting accounts through the tool. After that date, hospitals stopped holding accounts where the patient was insured, including public insurance companies like Medicaid. Most Medicaid patients are eligible for charity because of the program`s income requirements. If a patient rejects the initial request, hospitals ask staff to demand partial payments in advance and then try to force patients to pay for schedules.
If all else fails, hospitals allow staff to discuss financial assistance. After September 2019, hospitals also stopped providing presumed financial assistance when the tool revealed that the patient`s income was between 151 and 200 percent of the federal poverty line — income levels still allowed by Washington state law. Hospitals are located throughout the state, from Seattle to Spokane, from Walla Walla to Everett. In their communities, many of the hospitals are either the largest or the only hospital in their area. Sweden`s First Hill site is the largest hospital in the state with more than 800 beds. Together, these hospitals reported more than $18 billion in patient service revenues in 2020. “Charitable care helps low-income families avoid medical debt by providing financial assistance to those who qualify,” Ferguson said. “Hospitals cannot deceive Washingtonians about their legal right to access medical financial assistance. They must respect the law and ensure that low-income patients have access to the resources they need. Ferguson will also file an application for an injunction, unless the hospitals agree to cease their conduct while the case is ongoing. Hospitals train staff to “ask every patient every time” to pay their unpaid medical bills for every patient interaction, without adequately disclosing the availability of charitable efforts.
Assistant attorneys general Audrey Udashen, Will O`Connor, Aileen Tsao and Matthew Geyman, investigators Matthew Befort and Bau Vang, paralegal Jen Killoren and paralegals Josh Bennett and Michelle Paules are handling the case for Washington. Current law requires hospitals to care for Washington families, who account for up to 100 percent of the federal poverty level, without having to pay out of pocket, including co-payments and deductibles, once their insurance runs out. Hospitals are required to give cuts on their out-of-pocket spending in Washington, which is between 101 and 200 percent of the federal poverty level. Washington`s Charities Act requires all hospitals — for-profit and nonprofit, public and private — to provide some or all of the cost of basic health care to eligible low-income patients. The law applies to Washingtonians whose household income is at or below 200% of the federal poverty level. Contrary to its behaviour, Sweden proclaims in its Declaration of Values that hospitals “stand in solidarity with the most vulnerable, working to eliminate the causes of oppression and promote justice for all.” Providence declares that its mission is to “serve all, especially those who are poor and vulnerable.” Kadlec Regional Medical Center, also included in the Ferguson trial, also says it “serves everyone in our communities, especially the poor and vulnerable.” The non-profit Swedish Health Services operates two hospitals in Seattle and facilities in Ballard, Issaquah and Edmonds. Providence hospitals have sent more than 50,000 accounts of patients eligible for charitable care As part of the settlement, Swedish will train staff on the new procedures to ensure qualified interpreters are present for patients who need them. The hospital records the use of interpreters and provides this information to the U.S. Attorney`s Office every six months. In addition, the Medical Center will notify the U.S.
Attorney`s Office of any complaint alleging that Swedish First Hill failed to provide tools and support services to, or ensure effective communication with, patients or companions who are deaf, deafblind, or hard of hearing. Ferguson`s lawsuit alleges that Providence, Swedish and Kadlec have developed and promoted a corporate culture that prioritizes fundraising over charitable care, aggressively seeks to collect payments at the time of treatment, and continues to collect follow-up care even when hospitals know a patient is eligible for financial assistance.