No question that corporate health insurers are driving up health care spending. The higher their costs, the more money they make. Some hospitals are helping the insurers and hurting patients, with high charges, facility fees, and aggressive billing practices. MedPage Today reports on a lawsuit against Providence Health for failing to provide charity care to its low-income patients, as required by law.
Washington State’s Attorney General alleges in a lawsuit that Providence Health violated its obligation to its neediest patients. Instead of providing them with charity care, as required by law, it is failing to tell them about its charity care policy. What’s worse, it is billing them for the full cost of their care, sending their accounts to collection agencies and pushing them into medical debt.
It’s easy to appreciate that for-profit hospitals engage in aggressive billing practices. But, Providence Health, which operates 14 hospitals in Washington State and is the state’s largest hospital system, is a non-profit. In just two years’ time, Providence sent the accounts of 46,783 patients with incomes between 151 and 200 percent of the federal poverty level to collection agencies.
Washington State requires all hospitals to do what they can–“make a reasonable effort”– to ensure that eligible patients learn about the charity care they offer. They are not supposed to send their accounts to collection before they have made this effort.
Instead, Providence Health has its representatives lead patients to believe that they must pay their bills, notwithstanding their income level. Staff are told not to back down when patients report that they cannot pay their bills. Staff are supposed to ask for half upfront and then work out a payment plan with patients.
The suit claims that Providence sends many bills to collection with full knowledge that patients are low-income and cannot pay the bills. Whatever money it can extract, it wants. It appears that McKinsey & Company, a management consulting firm, helped Providence come up with the plan to avoid screening patients for charity care. Providence provided staff with scripts to use with patients that hid the availability of charity care from them.
That makes it a lot easier for Providence to talk the talk–claim that it offers free care to patients with incomes under 300 percent of the federal poverty level–without walking the walk.
Staff charged with collecting on hospital bills must reach specified targets and are assessed publicly. Not surprisingly, the lawsuit alleges that Providence Health does not make patients aware of its charity care policy when they are admitted, on discharge, or after patients explain that they cannot afford to pay for their care.
Here’s more from Just Care:
- Medicare hospital star-ratings are a farce
- For-profit hospitals are causing rising medical debt and personal bankruptcy
- Coronavirus: Booster shots reduce risk of hospitalization
- How to prepare for your hospital stay
- Coronavirus: What to do before you leave the hospital

