'They want money, regardless of my situation': hospitals began to sue debtors for medical bills - ForumDaily
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'They want money, regardless of my situation': hospitals began to sue debtors on medical bills

When considering civil cases in a courthouse in the southwestern city of Virginia, it turned out that many lawsuits have a common plaintiff: the local hospital, Ballad Health. She sued patients for unpaid medical bills, writes NY Times.

from: Depositphotos

In August, Ballad Health Hospital filed 102 of 160 lawsuits. The defendants included a school teacher, a correctional officer, a mother sitting at home, and even a Ballad Health worker - all had private insurance, but they still owed most of their bill.

Ballad, which operates the only hospital in Wise County and another 20 in Virginia and Tennessee, filed more than 6700 lawsuits last year due to patient arrears. Since 2009, Ballad Health has filed at least 44 000 lawsuits.

In almost all such cases, hospitals win cases. Only about a dozen patients came to a court hearing in August in Mudra, hoping to develop a payment plan or challenge the claim.

From Delaware to Oregon, hospitals across the country are increasingly suing patients for unpaid bills, a step many agencies have not wanted to take.

In some places, large hospitals now file hundreds or even thousands of lawsuits annually.

In Milwaukee, for example, a nonprofit children's hospital has sued 1101 patients since the start of 2018—more cases than in the entire previous decade. The city's only tertiary trauma center filed 2074 claims last year, more than double the previous year.

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And some of the country's most famous academic hospitals, including Johns Hopkins in Baltimore and New York-Presbyterian, have also sued more patients in recent years.

Hospitals say they are suing more often as deductibles increase, but the practice affects a small portion of their patients. They defend claims to pay off unpaid bills and keep the healthcare system afloat. “We only pursue patients who have the means to pay but choose not to pay,” said Anthony Keck, vice president of systems innovation at Ballad Health.

Patient and consumer lawyers say hospitals make erroneous assumptions about the solvency of insured patients. They also argue that lawsuits and wage benefits are most likely to affect middle- and low-income populations. A cashier at Providence Health, Oregon, said she brought 80 cents home for 54 hours of work. All this after seizure due to non-payment of bills and other deductions.

According to surveys, confiscation of wages forced patients to sign up for federal assistance programs, to be left behind in the bills, abandon their insurance and take out loans.

“I know I'm in debt, and of course I want to pay. It just seems like they want their money no matter what my situation is,” said Amanda Sturgill, 41, whose unpaid bills were brought to court by Ballad.

Amanda Sturgill earns 12,70 dollars by working full time, processing orders for audio equipment. She is undergoing a divorce and supports four children.

In June, Ballad sued her for more than 2498 dollars in outstanding debt for back surgery for her teenage daughter. Sturgeill has developed a payout plan for 150 dollars a month, but often struggles to find money.

“Sometimes if I'm getting close to a due date and I don't have any money, I go to a flea market and sell some of my stuff. It terrifies me because I don’t know what they will do if I fall behind on my payments,” she said.

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This type of debt collection for medical services has received increased attention from judges and state lawmakers. New York is considering legislation that will significantly reduce the statute of limitations for medical debt. Connecticut can reform its system to facilitate navigation for patients who rarely have legal representation.

Some hospitals that have drawn media attention to the prosecution of large numbers of patients, including one non-profit healthcare system at Memphis and another owned by the University of Virginia, have drastically reduced the use of medical debt litigation.

Others are stepping up the practice, often to the surprise of patients.

“I'm used to hospitals sending out debt notices. But I'm not used to the sheriff coming to my door to deliver a summons,” says Amanda Sturgill.

More than a decade ago, hospital managers could safely assume that patients with health insurance could probably pay their medical bills. According to the Kaiser Family Non-Profit Fund, in 2006, only about half of employer-sponsored health insurance plans deducted a deductible that employees had to pay out of pocket before their insurance coverage took effect.

Today, 82 percent of employer health plans have a deductible, and the average amount has nearly tripled to $1655 from $584. Low-wage workers are more likely to be offered high-deductible insurance, which is cheaper for employers.

An increase in expenses is also characteristic of those who buy medical insurance on their own. Plans purchased through the Affordable Care Act can significantly limit out-of-pocket costs: to 8 200 US dollars per person in 2020 year and 16 400 US dollars per family.

On the subject: Medicine in the USA: expensive and even more expensive

Non-profit hospitals are required to provide charity and other financial assistance, but are not required to check patients to determine their needs. The insured person may have a low enough income to qualify, but the hospital is unlikely to check, industry experts say.

“There was an assumption that if you have insurance, you have the ability to pay. But this is no longer necessarily the case. It's a mountain of patient debt, and hospitals don't know how to deal with it,” said James McHugh, managing director of healthcare consulting firm Navigant.

That means more lawsuits from places like Children's Wisconsin, a nonprofit organization that used to be known as Children's Free Hospital. In 2014, 23 lawsuits were filed and 108 in 2015. 671 case was initiated last year.

Last year, Children's Wisconsin was sued for amounts ranging from $46 ($270 with legal fees) to $20. The defendants include Holly Edwards, a manager at McDonald's and a single mother in Milwaukee who fell behind on payments for her 606-year-old daughter's emergency room visit.

"It's not that we decided not to pay, but there are other bills," Edwards, 43, said.

"My daughter has to eat, and if she has to choose between that or paying the doctor's bill, I'll choose my daughter," she added.

Edwards paid $300 a month to the hospital. But after some unexpected expenses—$450 to exterminate bed bugs—she began sending smaller amounts.

Last fall, the hospital brought her to court and recently began to take a quarter of her salary: 420 dollars in two weeks. Edwards worked on 14 hours per shift to make up for lost revenue, but still lagged behind in payouts.

On the subject: What I learned about medicine in the United States when I got insurance

A children's hospital cited two factors that led to a lawsuit lawsuit: higher deductibles and a growing number of patients. It states that lawsuits are the last resort after other attempts to collect patient debts.

In New York, lawsuits for medical debt are rare, but growing, as in New York-Presbyterian, the largest network of city hospitals. The number of lawsuits for medical debt doubled to 515 between 2015 and 2016. In 2017, the hospital sued 779 patients. The reason is all the same unpaid bills.

Hospital spokeswoman Kate Spaziani said that "the practice and policy of the hospital remains unchanged: we are actively working with suitable patients to help them gain access to our charitable care and advocacy programs."

In many cases, legal costs and interest increase the debt of patients.

System change

Government officials are increasingly worried about the spread of medical debt lawsuits, which has drawn media attention to practice at the nonprofit hospital network in Memphis, at the commercial hospital in New Mexico, and at the University of Virginia's healthcare system.

A University of Connecticut report released in June found that between 2011 and 2016, hospitals and state doctors sued 80 000 patients for medical debt.

Last month, New York lawmakers introduced a law that would limit interest payments to hospitals for medical debt at 3 percent instead of 9, and also reduce the statute of limitations from six to two years. Proposed changes may lead to a reduction in claims against patients.

The American Hospital Association, an industry trading group, has not taken an official stance on medical debt litigation.

Some hospitals are developing financial support policies that target high-deductible patients. This year St. Luke's University Health Network in Pennsylvania introduced a program to help insured patients who cannot pay their medical bills.

“Two years ago we didn’t do this and now we get 50 applications a week. We don't want people to go out of business because of us,” said Richard Madison, the chain's vice president of revenue cycle.

Ballad Health has no plans to change its forensic strategy. But the vice president, said the network is increasing the income limit for charity, which could reduce the number of lawsuits.

“We are a health care system that has to pay the bills. We have to pay nurses, doctors and so on. We are doing our best to keep the case out of court because it is expensive for everyone,” he added.

Mrs Sturgill, who pays for her daughter's back surgery, hopes to continue her pay plan and avoid seizing her wages. Her children continue treatment at Ballad Health.

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