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Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
Current rating: 0 |
by ML
(No verified email address) |
30 Oct 2003
|
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The News-Gazette has a hefty income from local health care providers, who often take out full page ads touting their services in the newspaper. Yet, there was no news in today's New-Gazette about a major local story, the publication of a front page article in today's (30 October 2003) Wall Street Journal detailing the aggressive collection practices utilized by local health care providers against those in poverty who cannot make payments on their bills. |
The News-Gazette has a hefty income from local health care providers, who often take out full page ads touting their services in the newspaper. Yet, there was no news in today's News-Gazette about a major local story, the publication of a front page article in today's (30 October 2003) Wall Street Journal detailing the aggressive collection practices utilized by local health care providers against those in poverty who cannot make payments on their bills.
This important news was announced today by Champaign County Health Care Consumers' Brooke Anderson, who was speaking at a forum at the University YMCA sponsored by the Graduate Employees' Organization. The forum was called to detail the situation of GEO members, who often suffer large bills due to inadequate insurance provided to graduate students by the University of Illinois.
Unlike many insititutions in the UI's cohort, which provide full health care packages to their graduate employees, often at no expense, the UI charges about $1,100 a year for health care with often inadequate coverage. Students with major illnesses or who are involved in an accident can face bills of thousands of dollars, while making only a couple of hundred dollars a week in wages. The UI may have Nobel Prize winners among its faculty, but it treats many of its workers like sweatshop labor when it comes to health insurance.
This situation can lead to student-employees facing huge bills. Local health care providers have a national reputation, detailed in the Wall Street Journal article, for aggressive and demeaning collection practices. These include over-billing, court action against clients in poverty (which includes most graduate students at the wage level provided by the UI), and the threat of arrest for what they owe.
One would think that such a major story would rate at least minimal coverage by the News-Gazette, but the story appears to be too hot for the N-G to handle. There was no coverage of this major story in today's paper.
Perhaps the N-G doesn't want to risk its lucrative advertising income from local health care providers by angering them by publishing this story locally. On the other hand, it must be rather embarrassing to the N-G to be scooped by a bastion of the capitalist press such as the WSJ on a story they have mostly ignored for years. In any case, it will be interesting to see if the story is ever mentioned in the N-G.
While the story itself is only available online to WSJ subscribers, here is the abstract from the WSJ's website:
How Some Hospitals Collect Debts
Hospitals such as Carle Foundation Hospital in Illinois are becoming some of America's most aggressive debt-collectors, putting increasing pressure on poor and uninsured patients to settle their bills.
Be sure and read the story at the library if you are not a Wall Street Journal subscriber. If you are a subscriber, you might consider posting a copy here on UC IMC as a public service, since it looks like there will be a media blackout on it locally.
Except for Indymedia, of course. |
Comments
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Wire Services Can Be Your Friend |
by Muck Raker
(No verified email address) |
Current rating: 0
30 Oct 2003
|
from SFGate.com
http://www.sfgate.com/cgi-bin/article.cgi?f=/news/archive/2003/10/30/financial0950EST0052.DTL
Hospitals go to extremes to collect their debts
LUCETTE LAGNADO, The Wall Street Journal Thursday, October 30, 2003
(10-30) 06:50 PST (AP) --
CHAMPAIGN-URBANA, Ill. -- Late one night in June 2000, a police cruiser pulled up to Marlin Bushman's house on a quiet, tree-lined street. While Mr. Bushman's wife and son stood by, an officer handcuffed the burly truck driver and took him away to jail. The charge: missing a court hearing about a $579 hospital bill.
The hospital that pursued Mr. Bushman, a 295-bed not-for-profit facility called Carle Foundation Hospital, is one of several that has at times employed debt collection tactics that are shunned by many other creditors. It has filed hundreds of lawsuits, garnisheed patients' wages and seized their tax refunds. Since 1995, Carle, the primary teaching hospital of the University of Illinois, confirms it has also sought 164 arrest warrants for debtors who missed court hearings.
In one case, Carle went after an uninsured, part-time musician whom it had treated for a gunshot wound in a suicide attempt. When the man, James Bean, missed a hearing on his $7,718 hospital bill, Carle asked the court for an arrest warrant, and in November 2001 Mr. Bean landed in jail for several hours.
In another case, Carle obtained an arrest warrant for an uninsured single mother, Kara Atteberry, who missed two court hearings on a $1,678 debt she incurred for a miscarriage. Ms. Atteberry turned herself in to authorities in October 2001 and was briefly jailed before making a $100 bail payment. She now owes a total of $2,070 to Carle, including a bill for other treatments, and she expects to file for bankruptcy.
Some hospitals now rank among America's most aggressive debt-collectors, as they put increasing pressure on poor and uninsured patients to pay their bills. Adding to the problem, as The Wall Street Journal has reported, hospitals generally charge uninsured patients far more than the discounted rates negotiated by health-maintenance organizations and other private insurers and government agencies.
Some also use one of the harshest and least-known collections tactics of all: seeking the arrest of no-show debtors. A review of court records and interviews with hospital trade groups, collections attorneys and consumer advocates shows that hospitals in several states, including Connecticut, Indiana, Kansas, Michigan and Oklahoma, have secured the arrest and even jailing of patients who miss court hearings on their debts.
The legal tactic of arresting a debtor who fails to appear for a court hearing -- known in some areas as "body attachment" -- is so extreme that some of the country's biggest commercial creditors say they never use it. For instance, Sears, Roebuck & Co. and Ford Motor Credit Co., the finance arm of Ford Motor Co., say they expressly prohibit their collections agents from asking judges to issue arrest warrants against no-show debtors. In many areas of the country, collections lawyers say, the procedure has been all but abandoned. Judges grant a creditor's request for a body attachment when someone misses one or more hearings or otherwise flouts a court's authority -- technically, it's not punishment for the debt itself.
In Connecticut, the state's largest hospital, Yale-New Haven, has obtained at least 65 civil arrest warrants in the past three years for debtors who have missed court hearings, according to an examination of New Haven County court records by a researcher for the Service Employees International Union, which represents some hospital workers. After several inquiries from the Journal, the hospital, which doesn't dispute the union's research, said it would severely limit the tactic.
In Champaign-Urbana, a county agency was so shocked by hospitals' debt-collection practices that it tried to strip Carle and another hospital of their tax exemptions as charitable institutions. The effort failed against Carle; the challenge to the other hospital, a 268-bed Catholic facility called Provena Covenant Medical Center, is pending. "This concept of debtor's prison, you read about it in Dickens, but it is still going on," says Laura Sandefur, a former member of the agency, the Champaign County Board of Review.
The hospitals' pursuit of body attachments is surfacing at a time when many major U.S. medical centers are under fire for their billing and collections practices. In June, the American Hospital Association, the industry trade group, issued a memo urging its 4,800 members to examine their bill-collection practices and demand that their collections agencies and lawyers "treat your patients with dignity and respect." Connecticut recently passed a law slashing interest rates that could be applied to hospital debt. In California, a bill that would have shielded patients from aggressive billing and collections was shelved this summer following heavy industry opposition. Illinois is holding hearings on how hospitals bill and collect from the uninsured. Meanwhile, Congress has launched an investigation into the practice of charging uninsured patients more than the discounted rates offered to insured patients.
Patient advocates argue there is a fundamental difference between medical debt and other types of consumer debt. "If it is a car or a vacuum cleaner, they will simply repossess it. What do you want them to do? Give the heart valve back?" says Jane Perkins, an attorney at the National Health Law Program in North Carolina.
For their part, hospitals say they are forced to recoup every dollar they can because health-care costs are soaring, and insurers and the government are cutting their reimbursements for services. Hospitals have also been squeezed by the rising numbers of the uninsured -- the total hit a record 43.6 million people this year -- who often don't pay their bills. Hospitals say they shouldn't be forced to bear the disproportionate financial burden of a national crisis.
"You can't solve the issue of millions of uninsured by simply turning to hospitals whose financial conditions are quite fragile and say, 'You do it,' " says Howard Peters, senior vice president of the Illinois Hospital Association, a trade group representing more than 200 institutions, including Carle and Provena Covenant.
Carle defends its debt-collection practices, emphasizing that body attachments are imposed by a judge as the legal result of a debtor's violating a court order. "We are not going door-to-door to put people in prison," says Carle's chief executive, James Leonard, 48, a family doctor who still occasionally practices medicine. "It is your choice to not show up in court."
In some cases, the debtors did appear for at least one court hearing. Ms. Atteberry says that when she did come to court, she was talked into accepting payment terms she couldn't afford -- including an order not to spend her tax-refund money. When the judge summoned her back, she didn't go because she feared "the whole hounding process" would start anew. "Who would want to show up?" she asks.
After inquiries from the Journal, Carle said it would permit its collections agencies to seek body attachments only after a review by a new, three-person committee consisting of two hospital employees and an outsider. Dr. Leonard says he still considers body attachments useful, but the panel will try to assess the "human story" behind each case. He says Carle, which handles 100,000 patient visits a year, goes to great lengths to serve Champaign's poor and uninsured, and has programs designed to provide discounted care. "We really are a microcosm of part of the struggle that is going on," Dr. Leonard says. "We are charged with sorting out who can afford to pay, who can't afford to pay. How do you set the rules?"
Carle says its policy is to refer bills to an outside collections agency once they are 100 days overdue. The hospital says it has authorized its collections agencies to pursue legal action on about 7,300 bills since 1995, but many of those cases were settled before a suit was filed. In response to inquiries from the Journal, the hospital searched its records from 1995 to 2003, and said it had obtained 164 body-attachment orders during that period. Carle said not all of the orders had resulted in arrests; some were vacated and others remain outstanding. The hospital wouldn't be more specific. It also said it has sought far fewer body attachments in recent years than previously.
Because Carle doesn't always file cases under its own name, the number of body attachment orders and arrests resulting from its collections lawsuits couldn't be independently confirmed. As recently as a few years ago, the hospital did file such cases under its own name, but since then suits against Carle debtors have increasingly been filed under the names of collections agencies. Gretchen Robbins, a Carle spokeswoman, says the hospital isn't trying to camouflage its legal activities, but rather its collections agencies increasingly file "consolidated" suits on behalf of multiple creditors, which she says is more efficient and cost-effective, saving court costs for both sides.
Mr. Bushman, the truck driver who was arrested in the middle of the night, has had a long struggle to pay his hospital bills. In a series of trips to the Carle emergency room over a period of five years, Mr. Bushman, who is diabetic, sought care for his wife and their three young sons. At times, the Bushmans were insured. Other times, they lacked coverage, or their insurance didn't cover the entire bill. They paid some of the Carle bills, but by late 1998, still owed $579 and had received several collections notices.
In February 1999, Carle filed a lawsuit in Champaign County Circuit Court seeking payment. Mr. Bushman appeared at a court hearing on the debt a month later. He says he couldn't afford a lawyer -- and in Illinois civil arrest cases, unlike criminal cases, the court isn't required to appoint one. At the hearing Mr. Bushman agreed to pay the full amount within a month, even though he says he wasn't sure he would have the money. After he failed to make the payment, the court ordered him to appear at another hearing at the end of April.
This time, he didn't show up. He says he was worried about losing a day's pay. He knew he was risking arrest, but he says, "I assumed I could probably take care of it later" and, besides, he says, he couldn't pay the debt. Mr. Bushman, who is now 40 and works as a mechanic, says he was "expecting some money from a tax return" but didn't get it.
The court, at the request of a lawyer for Carle's collections agency, ordered a body attachment. However, Mr. Bushman wasn't arrested right away. In Champaign County, body attachments are usually enforced only when an officer confronts someone for another incident or alleged offense.
About a year later, at 1:10 in the morning of June 13, 2000, Urbana police picked up Mr. Bushman's 16-year-old son for drinking and violating curfew laws, according to police records. When the officer brought the teenager home, his last name triggered an alert about the outstanding civil-arrest warrant against his father. Mr. Bushman's wife, Diane, remembers thinking, "You bring home my son and take away my husband?"
Mr. Bushman was booked and fingerprinted at the Champaign jail. He posed for a mug shot, turned over his shoelaces and was escorted to a cell. A judge imposed bail of $2,500 -- with $250 payable up front. Mr. Bushman waited in a cell while his wife tried to come up with the money. He says he fell asleep on the concrete bench, using a roll of toilet paper as a pillow. Ms. Bushman borrowed the money from her mother-in-law, and Mr. Bushman was freed a short time later. Within three months, he paid Carle the balance of his debt, and the case was dismissed.
Carle's chief financial officer, Robert Tonkinson, defends the use of a body attachment against Mr. Bushman. Mr. Tonkinson pointed out that Mr. Bushman had more than a year to pay his debt between the time the body attachment was imposed and the day he was arrested. "He landed in jail, and that is certainly where no one wanted him to be," Mr. Tonkinson says, "but I struggle with the personal responsibility on his part, and my responsibility as chief financial officer."
The use of body attachments -- known in some states as civil arrest warrants, bench warrants or writs of capias -- varies widely from state to state, and even from courtroom to courtroom, depending on such factors as the aggressiveness of local collections agencies and judicial sympathies. It isn't possible to determine how many hospitals nationwide use the procedure. In body-attachment proceedings, a collections lawyer acting on the creditor's behalf generally can request the arrest, which is then ordered by a judge.
Hospitals, industry trade groups, collection lawyers and consumer advocates in several states, including New York, Louisiana, Wisconsin and Texas, say they had never heard of hospitals seeking the arrest of no-show debtors. Laura Redoutey, president of the Nebraska Hospital Association, expresses shock at the tactic, and says she "can't fathom it has ever happened here." Stanley Brezenoff, president and chief executive of Continuum Health Partners, the elite New York hospital system that includes St. Lukes-Roosevelt and Beth Israel, says he has never heard of a New York hospital pursuing an arrest warrant related to a debt. "We are not in the business of replicating 'Les Miserables,' " he says.
Nonetheless, just last month in Evansville, Ind., the not-for-profit Deaconess Hospital sought the arrest of a 22-year-old debtor, Jamie Ruston, who had missed two court hearings on a $5,664 debt related to gynecological surgery. Ms. Ruston, who works at a McDonald's, was briefly in custody before her mother arrived at the jail with the $500 needed to secure her release. "I cried the whole time," Ms. Ruston says.
Alan Shovers, a lawyer for Deaconess, says the hospital, which is affiliated with the United Church of Christ, made "innumerable efforts to get in touch" with Ms. Ruston to work out a payment plan or to see if she qualified for charity care. "In the range of 16 times, she has ignored us, ignored the hospital, ignored the court house," Mr. Shovers says. He defends the hospital's use of bench warrants -- as the proceeding is known in Indiana -- saying the hospital seeks them only when debtors have been repeatedly unresponsive. "Most people, whether rich or poor or whatever, can to some degree respond to the system -- and you have some people who go through life without responding," he says. "The question is, are we taking some unfair advantage, and I don't think we are."
In Connecticut, one of the debtors pursued by Yale-New Haven hospital, John Franchi, 35, says a state marshal appeared at his East Haven home one Saturday morning last November and announced he was placing him under arrest and taking him to the local jail. "I have two little kids, and it was unbelievable," Mr. Franchi says. He was able to persuade the officer that he would appear court on his own the following Monday. "I didn't want to go to jail," he says. "I was terrified."
After appearing in court, Mr. Franchi, a warehouse supervisor, worked out a payment arrangement on his $3,978 debt for treatment he says was related to viral meningitis. He says the hospital is now garnisheeing a portion of his $14.50 hourly wages. "It is devastating me," Mr. Franchi says.
Yale-New Haven initially defended its use of writs of capias -- as the proceeding is called in Connecticut -- saying they were a useful way to compel recalcitrant debtors to appear. "If someone will be uncooperative and they ignore the legal system, what is the alternative?" said William Gedge, a Yale-New Haven hospital vice president. However, after inquiries from the Journal, Mr. Gedge said the hospital would severely limit the use of such warrants and would scrutinize each one that is sought.
Another debtor, Leslie Caplan Block of Newton, Conn., says she was home caring for her infant twins and 3-year-old daughter in September 2000 when two sheriffs' deputies arrived. They arrested her for missing a court date on a $9,454 debt she had incurred at Yale School of Medicine -- which is incorporated separately from Yale-New Haven hospital -- for surgery on one of her babies. After her father agreed to come over and watch the children, Ms. Block, now 34, was taken away in the back of the officers' car and was put in a holding cell while she awaited a judge. She was released after her husband paid $350 in bail money. "I was scared to death," she says. In the ensuing months, her debt swelled to $15,715, including interest and court costs.
Tom Conroy, a spokesman for Yale University, says the medical school has used writs of capias only as "a last resort." He says doctors at Yale medical school -- who care for patients at Yale-New Haven hospital -- don't inquire into a person's means before offering care. Mr. Conroy adds that the institution has vacated Ms. Block's debt.
In Champaign-Urbana, James Bean, the man who was treated at Carle hospital for a self-inflicted gunshot wound, says he has been pursued aggressively by a collections agent since 1995, when the hospital sued him over his $7,718 bill. In June 2001, Mr. Bean, who says he held a series of odd jobs during that period and couldn't afford a lawyer, missed a court hearing. He says he wasn't aware of the hearing. Carle's lawyer obtained a warrant for his arrest, and a few months later, Mr. Bean says, he heard about the warrant and turned himself in. Bail was set at $3,500, and he spent six hours in jail before his brother came up with the 10 percent required to release him.
Five months later, in April 2002, Mr. Bean missed another court hearing, which he also says he wasn't aware of, and Carle requested another body attachment. The judge granted it and set bail at $5,000, but in July the order was revoked when Mr. Bean made a small payment.
Mr. Bean, 44, has recovered from the shotgun wound to his neck and now works as a stage hand. He says he tried to kill himself because he was despondent over the breakup of his marriage. Since then, he made payments totalling $1,340 to Carle, but because of interest and court costs, his debt swelled to $10,345. "It has been a nightmare," he says. "Is there ever going to be an end to it?"
Ms. Robbins, the Carle spokeswoman, says the hospital acted appropriately after Mr. Bean had failed for years to pay his debt. The suicide attempt was in 1991, and Carle unsuccessfully tried to collect for more than four years before filing suit. She says the hospital also encouraged Mr. Bean to apply for the state's insurance program for the poor, but that he didn't follow through.
"It doesn't appear as if we were incredibly aggressive in seeking payment," Ms. Robbins says. "There are many tragic situations we see day in and day out, and so there is a time for people to work through their grief, (and) there is time for them to deal with the finances of their medical care." Ms. Robbins adds that Mr. Bean's bill didn't have a code that indicated a suicide attempt, so "the folks that process this wouldn't have known." After inquiries from the Journal, Ms. Robbins says Carle's collection lawyer had agreed to eliminate Mr. Bean's interest charges, and that Mr. Bean now owes the hospital $6,535.
Carle also defends its pursuit of its October 2001 body attachment against Ms. Atteberry, 26, the single mother whose $1,678 debt had resulted from a miscarriage. Ms. Atteberry, who then was working as a waitress at a local pizzeria and is now unemployed, says she turned herself in to authorities after her shift ended one evening. She says she didn't want to be arrested in front of her two daughters. At the time, one was 3 years old and the other 3 months.
Ms. Atteberry was also the subject of an earlier body attachment order in August 1998, stemming from a debt of $1,514 that she incurred for various medical treatments in the mid-1990s at both Carle and Provena Covenant. Ms. Atteberry, who then was working at Kentucky Fried Chicken, says she turned herself in to authorities the following month, even though she was nine months pregnant. "I was freaking out," she says. "I didn't want to go into labor when they arrested me." She was detained in a jail cell for under an hour while her $250 bail payment was being processed.
Cheryl Harmon, Provena Covenant's chief financial officer, says the treatment of Ms. Atteberry was consistent with general practices in the industry. Ms. Harmon says Provena Covenant filed several hundred collections lawsuits a year in the mid-to-late 1990s, but a change of philosophy and collections agencies has drastically reduced that number -- to as few as 19 in 2002. A court search revealed that Provena Covenant obtained a body attachment against one of its debtors as recently as February 2003. That patient, who was briefly arrested in March, couldn't be located for comment.
Provena Covenant has "made a number of changes to make sure we aren't sending people to collection who cannot pay," Ms. Harmon says. "It really has been a soul-searching to find a way to distinguish between those who can't pay and those who can." Provena Covenant says Ms. Atteberry has paid $764, and the hospital has "purged" the rest of her debt. Earlier this month, in response to inquiries from the Journal, Provena Covenant's chief executive, Mark Wiener, 47, said the hospital would no longer pursue body attachments.
Ms. Robbins, Carle's spokeswoman, says Ms. Atteberry ignored numerous efforts to reach her. "We sent statements and we sent her letters," and also telephoned Ms. Atteberry and left a message with her father, Ms. Robbins says. Noting that Ms. Atteberry could have avoided the court proceedings by communicating with the hospital. She probably would have qualified for discounts or other financial assistance, Ms. Robbins says: "There is only so much we can do for folks." |
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The News-Gazette: Obeisant Stenographer To Power |
by ML
(No verified email address) |
Current rating: 4
31 Oct 2003
Modified: 05:49:29 PM |
Well, we finally got what passes for coverage of this story in the News-Gazette. Headlining the top of the frontpage of the B section is a story entitled "Hospitals defend debt-collection practices". That headline shared the top of a page with another story titled "Carle recognized for heart services" in a rather bald attempt to dilute whatever negative impact the Gazette's watered down story by Debra Pressey would give these institutions who were the subject of the Wall Street Journal's national story on Champaign County health care providers' odious medical debt collection practies.
Basically a report of interviews with executives from Carle and Provena, the article offered little but "don't blame us" mea culpas. Saying he was "disappointed" in the Wall Street Journal's article, Carle's CEO said that they're just "people trying to work with people" in defense of local debt collection practices that include issuing warrants for the arrest of those in medical debt. Left unaswered was why such parctices are used locally, when hospitals in many other places find no need for such tactics.
The featuring of Leonard's remarks also implied that the WSJ article was somehow unfair or biased. Yet the WSJ interviewed, not just officials of the hospitals, but also patients and consumer advocates, among others. Of course, the News-Gazette saw no need to interview anyone except hospital officials. Readers can decide for themselves whose coverage of this important issue is more "disapointing" when it comes to journalistic practice and editorial balance.
Readers of the News-Gazette story would not have a clue that such debt collection practices are uncommon and regarded as ethically suspect by many other health care providers. As the story reports, such practices are only available in places where the local judiciary is willing to cooperate. This raises once again the many issues that the Champaign County justice system has with citizens who are economically disadvantaged. The cozy symbiosis between some members of the local legal community, the courts, and the hospitals is a large part of the problem. Why should taxpayers bear the cost of enforcing such debt collection practices? And who are the judges that issue such warrants? These are parts of the story we need to know more about. |
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by Z. A Abonn
ritri29tn (nospam) aol.com (unverified) |
Current rating: 0
01 Nov 2003
Modified: 04:31:14 PM |
Thank you ML and IndyMEdia of CU for reporting on this crucial issue!
Just a couple of things. One is that it is remarkably curious as to why the Wall Street Journal outright neglected to quote (or interview?) any of the folks from the Champaign County Health Care Consumers (CCHCC) for this article. If you go to the Google search engine as I did, it would appear that CCHCC is a major voice for medical debt reform not only in Illinois but also the rest of the nation. CCHCC, (and I do not speak or represent CCHCC in any way, shape, or form), CCHCC, it would appear, has both a local and a national track record on this issue and it also appears (at least by my very modest effort on the Google search engine) that CCHCC might be well qualified to have been featured fully in the WSJ article and any other local and national articles on medical debt.
Two, if you want to see some of CCHCC's national work on medical debt go to <www.accessproject.org>. and look under its reports menu. The Access Project web site has also the newest report on the problem of medical debt titled "National Report on Federal Policies and Hospital Practices that Contribute to Medical Debt."
Many thanks again,
Z. A Abonn |
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by Z. A. Abonn
ritri29tr (nospam) aol.com (unverified) |
Current rating: 0
01 Nov 2003
|
THIS IS TH ETEXT OF ILLINOIS SENATE BILL 522--TRUTH IN HOSPITAL BILLING (TO END DISCRIMINATION IN MEDICAL DEBT PRACTICES). CCHCC IS BEING PROMOTING THIS BILL FOR EXCELLENT REASONS AND I THINK WE SHOULD ALL SUPPORT CCHCC'S EFFORTS TO SCHEDULE A HEARING ON THIS BILL IN CHAMPAIGN-URBANA. THE LAST HEARING WAS HELD IN THE MIDDLE OF OCTOBER IN CHICAGO.
HERE IS THE TEXT OF THE BILL--ENJOY
Z. A. ABONN
093_SB0552
LRB093 03367 AMC 06106 b
1 AN ACT concerning health facilities.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 Truth in Hospital Billing and Finances Act.
6 Section 5. Findings. The General Assembly finds that:
7 (1) The rising cost of health care and services
8 provided by health care facilities is a matter of vital
9 concern to the people of this State and has a direct
10 relationship to the ability of the people to obtain
11 necessary health care.
12 (2) The citizens of this State have an inherent
13 right to receive and have available to them health care
14 programs and services that are capable of meeting
15 individual needs.
16 (3) The public cannot make informed decisions about
17 personal health care without access to information about
18 the facilities that provide it.
19 Section 10. Purpose. It is the purpose of this Act to
20 provide that the facilities and organizations covered by this
21 Act shall make a public disclosure of their financial
22 position and their policies concerning the treatment of those
23 without full insurance and to ensure consumers timely access
24 to information regarding hospital charges and collection
25 procedures.
26 Section 15. Definitions. For the purposes of this Act,
27 unless the context requires otherwise:
28 "Annual report" means an annual financial report for the
29 health care facility's or related organization's fiscal year
-2- LRB093 03367 AMC 06106 b
1 prepared by an accountant or the covered facility's or
2 related organization's auditor.
3 "Bad debt" means charges for which payment was expected
4 but not received.
5 "Charity care" means health care services provided
6 without charge with no expectation of payment valued at cost
7 as determined by multiplying the hospital charge by the
8 cost-to-charge ratio. "Charity care" shall not include
9 Medicare and Medicaid shortfalls.
10 "Covered facilities" means hospitals and related
11 organizations.
12 "Department" means the Department of Public Health.
13 "Gross patient revenues" means gross revenues received
14 from program services, including bad debt and charity care.
15 "Hospital" means a health care facility licensed under
16 the Hospital Licensing Act.
17 "Net patient revenue" means revenue excluding contractual
18 allowances, negotiated discounts, charity care, and bad debt.
19 "Related organization" means an organization, whether
20 publicly owned, nonprofit, tax-exempt, or for-profit, that is
21 related to a hospital through common membership, governing
22 bodies, trustees, officers, stock ownership, family members,
23 partners or limited partners, including but not limited to
24 subsidiaries, foundations, related corporations, and joint
25 ventures. An organization is considered to be related to a
26 hospital if one of the following conditions is met:
27 (1) The organization controls or is controlled by a
28 hospital through contracts or other legal documents that
29 give the organization the authority to direct any of the
30 hospital's activities, management, or policies or allow
31 the hospital to direct any of the organization's
32 activities, management, or policies.
33 (2) The organization has solicited funds in the
34 name of the hospital with the express or implied approval
-3- LRB093 03367 AMC 06106 b
1 of the hospital and a substantial portion of the funds
2 was intended by the contributor or was otherwise required
3 to be used for the benefit of the hospital.
4 (3) The hospital has transferred resources to the
5 organization and a substantial portion of the
6 organization's resources is held for the benefit of the
7 hospital.
8 (4) The organization has transferred resources to
9 the hospital and a substantial portion of the hospital's
10 resources is held for the benefit of the organization.
11 (5) The hospital has assigned certain of its
12 functions to the organization, which is operating
13 primarily for the benefit of the hospital.
14 (6) The organization is wholly owned or was created
15 by the hospital, and the hospital receives any of the
16 profits of the organization.
17 (7) The hospital is wholly owned or was created by
18 the organization, and the organization receives any of
19 the profits of the hospital.
20 (8) In the event of the dissolution of the related
21 entity, substantially all of the assets of the entity
22 would become property of the creating entity.
23 Section 20. Annual public disclosure report.
24 (a) Every covered facility shall file with the
25 Department an annual public disclosure report prepared by the
26 covered facility's auditor or independent accountant within
27 120 days after the end of its fiscal year, unless an
28 extension is granted by the Department for good cause shown.
29 (b) The annual public disclosure report shall be for
30 each individual hospital or related organization. If the
31 hospital or related organization is a division or subsidiary
32 of another entity that owns or operates other hospitals or
33 related organizations, the annual public disclosure report
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1 shall be for the specific division or subsidiary and not for
2 the aggregate of or combined hospitals or related
3 organizations of the other entity.
4 (c) The annual public disclosure report shall contain
5 all of the following:
6 (1) A complete audited financial statement for the
7 preceding fiscal year prepared and presented by an
8 independent accountant or the auditor of the covered
9 facility. All notes, schedules, and documents as required
10 by the nationally recognized auditing guidelines shall
11 accompany the financial statement.
12 (2) A note or addendum to the audited financial
13 statement that includes all of the following:
14 (A) Gross patient revenues categorized by
15 payer source.
16 (B) Net patient revenues categorized by payer
17 source.
18 (C) Bad debt by payer source.
19 (D) The monetary valuation and type of charity
20 care provided, reported by payer source and valued
21 at cost as calculated by multiplying the
22 cost-to-charge ratio by the charge. For the purpose
23 of this item (D), "at cost" shall be calculated by
24 applying the cost-to-charge ratios derived in
25 accordance with generally accepted accounting
26 principles for hospitals to charges. The calculation
27 of the cost-to-charge ratios shall be based on the
28 most recently completed and audited Medicaid Cost
29 Report. The 7 categories of payer source are
30 Medicare, Medicaid, Commercial, HMO,
31 Self-administered, Self-pay, and Other.
32 (3) Debt collection policies and procedures,
33 including policies for identifying third-party payers and
34 procedures for pursuing court action.
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1 (4) Charity care definitions, application
2 procedures, policies, and means of informing the public
3 about charity care.
4 (5) A complete schedule of current charges for all
5 patient services provided by the covered facility at the
6 close of its fiscal year.
7 (6) A statement of services available and rendered.
8 (7) Proof of public notification that the annual
9 public disclosure report is available.
10 (d) Every covered facility shall also file with the
11 Department the following statements, reports, and schedules
12 in such form and at such intervals as may be specified by the
13 Department, but at least annually:
14 (1) The approved budget and the annual capital
15 expenditures budget for the upcoming fiscal year that
16 sets forth the total financial needs of the covered
17 facility and the resources available or expected to
18 become available to meet such needs.
19 (2) If the covered facility is certified under the
20 federal Medicare or Medicaid programs, a complete copy of
21 all cost reports submitted to the Medicaid State agency,
22 Medicare intermediaries, or other State agency
23 administering legislative directed funding. If such a
24 report is not prepared by the facility or organization
25 within a given fiscal year, then it shall file a complete
26 schedule of costs allocated to each category of costs in
27 accordance with standards established by the State
28 Medicaid office.
29 (3) A copy of such reports made or filed with the
30 Center for Medicare and Medicaid Services, including the
31 Wage and Salary Survey.
32 (4) A statement of all charges, fees, or salaries
33 for goods or services rendered to the covered facility or
34 related organization for the period reported that exceed
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1 in total $55,000 and a statement of all charges, fees, or
2 other sums collected by the covered facility for or on
3 the account of any person, firm, partnership,
4 corporation, or other entity, however structured, that
5 exceed in total $55,000 during the period reported. This
6 requirement does not apply to payments made or due as a
7 result of services rendered to patients, clients, or
8 residents to whom the covered facility typically provides
9 services.
10 (5) A copy of all tax returns required to be filed
11 by federal and State law.
12 (e) The annual public disclosure report shall be made
13 available to consumers upon request at the Department of
14 Public Health and on-site at each hospital.
15 Section 25. Patient access to bills. Hospitals shall
16 include on their admission forms a conspicuous notice stating
17 that the patient may, upon request, receive a copy of all
18 individual hospital charges related to the patient. Admission
19 forms shall also include a conspicuous notice specifying the
20 name and contact information of a person whom the patient may
21 contact to request a copy of the hospital charges related to
22 the patient.
23 Hospitals shall include in their bills to patients, and
24 to any third-party payers unless previously furnished, an
25 explanation of any items identified by any code or initial.
26 Within 30 days of a request by a patient, a hospital shall
27 provide the patient an itemized bill free of charge. The
28 itemized bill shall identify, in plain language, each
29 individual service, supply, or medication provided to the
30 patient by the hospital, the specific charge for the service,
31 supply, or medication, and the name and contact information
32 of a person whom the patient may contact with questions.
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1 Section 30. Department reports. The Department of Public
2 Health shall prepare an annual report to the General Assembly
3 listing those hospitals that have failed to comply with the
4 requirements of this Act. The Department of Public Health
5 shall use the information submitted to prepare reports at the
6 request of the General Assembly or the Governor. From time to
7 time, the Department may engage in or carry out analyses and
8 studies relating to health care costs, the financial status
9 of any covered facility or related organization, or any other
10 appropriate related matters, and may make determinations of
11 whether, in its opinion, the rates charged by a covered
12 facility are economically justified. The Department shall
13 use the information submitted to publish charts on its
14 website comparing charges by procedure and by facility for
15 procedures identified by the Department.
16 Section 35. Confidentiality and public availability. No
17 report, statement, schedule, or other filing required or
18 permitted to be filed with the Department under this Act
19 shall contain any medical or individual information
20 personally identifiable to a patient or a consumer of health
21 services, either directly or indirectly. All such reports,
22 statements, and schedules filed with the Department under
23 this Act shall be open to public inspection and shall be
24 available for examination during regular hours. Copies of the
25 reports shall be made available to the public upon request.
26 The annual public disclosure report for each hospital and its
27 related organizations shall be open to public inspection and
28 shall be available during regular hours at the hospital site.
29 Tax returns filed by for-profit hospitals shall remain
30 confidential, and the Department, its officers, employees, or
31 agents shall not divulge or make any part known. The
32 Department may release statistical data based upon these
33 records.
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1 Section 40. Verification of information. Whenever
2 further fiscal information is deemed necessary to verify the
3 accuracy of any information set forth in a statement,
4 schedule, or report filed by a covered facility under the
5 provisions of this Act, the Department shall have the
6 authority to require the production of any records necessary
7 to verify that information
8 Section 45. Whistleblower protection.
9 (a) A covered facility subject to the provisions of this
10 Act may not discharge, demote, threaten, penalize,
11 discriminate, or retaliate against any person or employee
12 with respect to compensation, terms, conditions, or
13 privileges of employment as a reprisal because the person or
14 employee, acting in good faith, individually or in
15 conjunction with another person or persons does any of the
16 following:
17 (1) Reports a violation or suspected violation of
18 this Act to a public regulatory agency, a private
19 accreditation body, or management personnel of the
20 covered facility.
21 (2) Initiates or cooperates or otherwise
22 participates in an investigation or proceeding brought by
23 a regulatory agency or accreditation body concerning
24 matters covered by this Act.
25 (3) Informs or discusses violations or suspected
26 violations of this Act with other employees,
27 representatives of employees, patients or patient
28 representatives, or the public.
29 (4) Provides or attempts to provide information to
30 the Department regarding possible violations of this Act.
31 (b) An employee is presumed to have acted in good faith
32 if the employee reasonably believes that the information
33 reported or disclosed is true and that a violation has
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1 occurred or may occur.
2 (c) A person or employee or former employee subject to
3 the provisions of this Act who believes that he or she has
4 been discharged or discriminated against in violation of this
5 Section may file a civil action within 3 years after the date
6 of the discharge or discrimination. If a court of competent
7 jurisdiction finds by a preponderance of the evidence that a
8 violation of this Section has occurred, the court may grant
9 the relief it deems appropriate, including any of the
10 following:
11 (1) Reinstatement of the employee to the employee's
12 former position.
13 (2) Compensatory damages, costs, and reasonable
14 attorney fees.
15 (3) Other legal and equitable relief to remedy the
16 violation, as may be appropriate to effectuate the
17 purposes of this Act.
18 (d) The protections of this Section do not apply to any
19 employee or person who (i) deliberately causes or
20 participates in the alleged violation or (ii) knowingly or
21 recklessly provides substantially false information to the
22 Department.
23 Section 50. Penalties. The Department may assess a civil
24 penalty against a covered facility that fails to submit the
25 materials required by this Act. The penalty may not exceed
26 $1,000 for each day a report is delinquent after the date on
27 which the report is due.
28 Section 55. Third-party payor identification.
29 (a) Each hospital shall make every reasonable effort to
30 determine the existence or nonexistence of a private or
31 public third-party payor that might cover in full or in part
32 the charges for care rendered by the hospital to a patient.
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1 (b) An initial determination of sponsorship shall
2 precede collection efforts directed at the patient.
3 Collection efforts may not be undertaken by the hospital
4 toward the patient if the insurance company is currently
5 processing the claim or the patient has appealed the decision
6 of the insurance company.
7 (c) At the time of admission, the hospital shall provide
8 each patient that indicates that he or she does not have a
9 third-party payor a language-appropriate list of the
10 eligibility policies and procedures for receiving Medicaid,
11 Medicare, charity care, and any other indigent medical
12 programs provided by the hospital.
13 (d) At the time of admission, the hospital must also
14 provide a language-appropriate written description of payment
15 options and debt collection practices and procedures.
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by pm
(No verified email address) |
Current rating: 0
04 Nov 2003
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I had the displeasure of watching the TV news on the night that this story broke, and it was just as bad as the Gazette's take. Their hook was that a bad liberal newspaper (the Wall Street Journal) unfairly targeted the defenseless Carle Hospital, then they switched to the story about Carle winning an award. Channel and Channel 15 were equally bad.
Did Carle's PR office feed that story to the media outlets? Did Carle's PR office write the article? Advocates do that sort of thing all the time, but the editors need to make decisions about what they run, and the evidence strongly suggests Foreman & Co. took THIS story to protect their advertising revenues.
I'd like to see Carle's media release. |
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by gg
(No verified email address) |
Current rating: 0
04 Nov 2003
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Here is the News-Gazette article. It was published Oct 31st. |
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by gg
(No verified email address) |
Current rating: 0
04 Nov 2003
|
Here is the News-Gazette article. It was published Oct 31st.
By DEBRA PRESSEY
© 2003 THE NEWS-GAZETTE
Published Online October 31, 2003
URBANA Carle Foundation Hospital and Provena Covenant Medical Center are defending their debt-collection practices after both were featured prominently in a Wall Street Journal story Thursday about how hospitals pursue patients who don't pay their bills.
The story focused largely on Urbana-based Carle as an aggressive collector of its patients' long overdue debts, but it identified both hospitals as having permitted the use of so-called "body attachment" procedures that involve the arrest of overdue debtors who don't show up in court.
Carle's Chief Executive Officer Dr. Jim Leonard said he was disappointed the story focused so much on the issue of body attachments. But, he said, he hopes it sparks a much-needed national discussion of what he sees as the broader problem a system that is failing the underinsured who are basically the working poor.
People on Medicaid and the uninsured who genuinely can't afford to pay are generally covered by Carle's charity care program, he said, but "the underinsured to me, that's where the big gap is."
Leonard said he condones the occasional use of body attachments in extreme cases where people have refused over the long term to communicate with Carle, collection agencies and the court.
"I don't know what else we can do when somebody won't deal with us," he said, adding it's not just Carle involved at that point, but "a contempt of court situation."
Leonard also said he is comfortable with the tactic because it doesn't involve an active warrant, and a person would only be picked up by police in connection with its Carle debt if he or she comes into contact with a law enforcement agency for some other reason.
Provena Covenant spokeswoman Ellen Cole said that hospital has amended its debt collection policy to specify body attachments aren't permitted in the collection process.
"It was something that had not been in our policy in the past, and we wanted to make sure that was something that was stated in the new policy," she said.
Provena Covenant's new policy, announced this past summer, also included reviewing all overdue debt cases scheduled for legal action to see if the patients would have qualified for the hospital's charity care program and offering it to those patients retroactively.
In its new policy, the hospital also vowed to be more aggressive about letting patients in the hospital know about the charity care option.
Cole said Provena's new policy was precipitated by a change in high-level hospital executives and had nothing to do with knowing about the upcoming Wall Street Journal story or a pending case before the Champaign County Board of Review, which is challenging the hospital's not-for-profit tax status and questioning, among other things, whether the hospital really provides charity care to all those who need and apply for it.
Leonard said he feels obligated not only to those patients who don't pay their bills, but to those who do, and that also means keeping the hospital solvent and operating.
He said organizations such as Carle aren't just anonymous entities.
The Carle staff members dealing with people and their hospital bills are also people who live in the community, he said.
"It's people trying to work with people," Leonard added.
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by JMohr
mohrjimmy (nospam) hotmail.com (unverified) |
Current rating: 0
07 Nov 2003
Modified: 01:01:53 PM |
I think what people should realize is the hospital (Carle) is not going after people who are not paying their bills. They are going after people who are not making any effort to contact the hospital about their bills. If people cannot afford healthcare there are avenues to take to help them. Ignoring the bills, not returning the phone calls, and hiding behind your curtains are not how to resolve debt.
If you were to go to any place of business and receive services you would be required to pay for them. Why shouldn't healthcare be any different? This is not a socialist state (yet). Provena Covenant is a not for profit organization and justly deserves that status. I have personally witnessed countless bills that were 'taken off of the books' because of the patients financial status. I can not argue for Carle hospital but how many phone calls, letters, etc. do they have to send before they get the information they need.... i.e. Can you pay this bill?
But I guess its asking too much for people to pay their bills.... |
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Provena's Not-for-Profit Status: In Question |
by ML
(No verified email address) |
Current rating: 0
07 Nov 2003
|
I would not say that you should believe everything you read in the News-Gazette, but today's edition carries the latest of several storeis about the revocation of Provena's not-for-profit property tax status by the bi-partisan Champaign County Board of Review. In large part, this is based on their denial of "charity care to all who need and apply for it, as case law requires."
It would seem that this is a lot more than a simple issue of people not paying their bills or making other arrangements. Perhaps Provena "has got religion" on this issue since their tax status has come into question, but this certainly indicates that a significant number of people have, in fact, been denied when it comes to having their bills waived due to poverty. |
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by John Hilty
jhilty (nospam) shout.net (unverified) |
Current rating: 10
07 Nov 2003
Modified: 11:38:21 PM |
In the past, both local hospitals have been aggressive in dealing with hospital debts. Consider the case of Mr. Bean in the Wall Street Journal article. I have heard that Mr. Bean was taken to court by Carle Hospital 13 times over his hospital bills. He showed up every time, stating that he was a college student and part-time musician, and didn't have the money to pay the hospital bills. It should be noted that Carle Hospital's attorney didn't always show up for these court hearings, and was never arrested. Finally, Mr. Bean was summoned to court the 14th time, but for some reason never found out about the hearing. When an acquaintance found out that a warrant had been issued for his arrest, Mr. Bean turned himself in and was arrested. He was later released. Therefore, it is not necessarily true that the people owing money to the local hospitals are hiding from their creditors, as the local media have portrayed this. Mr. Bean will be interviewed by Mick Wolf on WEFT (FM 90.1) at 10:30 a.m. on Sunday morning (Nov. 9th) regarding these events.
As for Provena Covenant, I know for a fact that many elderly women on limited income (social security) have been taken into collections by Provena Covenant. Many of the former Medicare 100 recipients (who are by definition poor, otherwise they couldn't have participated in the program) called up the hotline of CCHCC to complain about this. This happened while Diane Friedman was CEO of Provena Covenant.
One reason that is often used by the hospitals to justify their aggressive behavior is that they have tight budgets themselves and bills to pay, while insurance reimbursements have become less generous through the years. And yet, if you look at their financial statements, both local hospitals are profitable and have experienced strong growth in their yearly revenues (often in double digits). Furthermore, both local hospitals have engaged in expensive building projects in the recent past (and even the present, in the case of Carle). And so, how can they plead poverty?
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by John Hilty
jhilty (nospam) shout.net (unverified) |
Current rating: 7
07 Nov 2003
Modified: 11:59:08 PM |
To continue:
Representatives of the hospitals state that their debt collection practices are consistent with "industry standards." And yet, the American Hospital Association has issued a set of guidelines indicating that many of these debt collection practices are NOT in accordance with the standards of the hospital profession. In particular, the American Hospital Association urges its members NOT to arrest people for medical debt, nor should people living in poverty be taken to court over their hospital debts.
Furthermore, in the past both local hospitals have made it unnecessarily difficult to apply for their charity care programs. As a matter of fact, many people taken to court over their medical debts didn't even know the hospital(s) had any charity care program(s) because no one ever told them!
More recently, it appears that these problems with the charity care program have been addressed by the new CEO of Provena Covenant, Mr. Weiner., and new policies governing this program have been implemented. Also, Provena Covenant has terminated the use of "body attachments" under the direction of the new CEO, although Carle still hasn't entirely abandoned the practice of arresting people for their medical debts. There has been some improvement on these issues recently, particularly on the part of Provena Covenant. So it appears that some of the publicity surrounding these issues is facilitating constructive change. Hopefully, it will continue.
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Re: Champaign County Health Care Practices Make Front Page Of Wall Street Journal: News-Gazette Ignores Story |
by blessing
ibukospet2010 (nospam) yahoo.com (unverified) |
Current rating: 0
21 Jun 2005
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there should be adequate facilities 4 student to ues as there learning environment thanx |
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