Hold Hospitals Accountable

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A Good Day To Advocate for Better Healthcare

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Hospitals and Charity Care

We’ve had articles in the past on this subject. In fact, here’s one for reference. We expect that if a hospital is non profit then they will offer charity care.

According to a study, for-profit hospitals have a higher percentage of charity care as a portion of their total expenses than nonprofit hospitals. For large hospitals, the average percentage of charity care for for-profit hospitals is 3.72%, while it's 2.60% for nonprofit hospitals.  Doesn’t seem fair does it? You would expect that non profits, who reap a large federal and state benefit by paying no income or real estate tax would offer more. In fact, the federal rules have no minimum requirement for charity care. Here is a link to that law.

Senator Bernie Sanders released a report on the subject of nonprofit hospital charity care. He is chairman of the Senate Health, Education, Labor and Pensions committee. He found six of the biggest nonprofit hospital systems dedicated less than 1% of their total revenue to charity care in 2021 — what should be a key criteria for maintaining their tax-exempt status. Unfortunately it is not in most states. It actually gets worse because so many of these hospitals operate as predators and refer patients to collection when they can no longer pay their bills, instead of offering charity care.

One study, mentioned in his report, found that in 2017 tax exempt hospitals billed patients $2.7 billion when they should have eligible for charity care. Hospitals make it hard to figure out how to access charity care that they are supposed to offer. The reference is in the linked report (#12)

Well, the state of Washington took action. They didn’t specify a minimum charity care percentage that hospitals have to offer, but they specified that patients whose income was within certain limits had to be offered assistance. AND it applies to all hospitals, not just nonprofit hospitals.

Here is a link to Washington’s Charity Care Law. Here is a chart from the Attorney General’s website that demonstrates how assistance is to be offered.

That website also has a calculator so you can determine how much help the hospital has to offer you.

One of the bigger hospital systems in Washington is Providence. The attorney general’s office investigated and found that Providence created barriers for thousands of patients who were legally entitled to financial aid for their medical bills. They not only failed to notify patients about this financial assistance, as the law requires, but also kept collecting payments and sent many of their most vulnerable patients to debt collectors.

One of Providence’s own employees summed it up pretty well. They called the practice, “sending the poor into bad debt.”

Providence must provide $157.8 million in refunds and debt forgiveness for nearly 100,000 Washingtonians.

Patients will receive checks in the mail or notice that their account balances have been written off. If patients have questions about whether they qualify for this resolution, they should contact Providence. The Attorney General's Office does not have patient data. Providence can be reached at 855-229-6466.

This is the largest resolution in U.S. history for a case like this.

It would be nice if all states had such a law or better yet if it were a federal law for all of us.

ACTION

Let’s let our elected representatives in Washington D.C know about the problem and that a law like the one in Washington State is a good way to go. Contact info for Members of Congress and Senators is in the Resources section below.

Or use RESISTBOT to send the message below by texting SIGN PAACMD to 50409.

“I am your constituent and I want you to know that hospitals, especially tax exempt nonprofit ones, do a poor job of offering charity care. Washington State has a new law that forces hospitals (all of them) to offer assistance to those with low incomes. Here is a link to that law, https://www.atg.wa.gov/charitycare#:~:text=The%20law%20ensures%20all%20Washingtonians,assistance%20depending%20on%20the%20hospital.

I want you to consider implementing this at the federal level. At the very least apply it to those that get federal tax exemptions, since there is no minimum for charity care in the IRS code. Thank you.”

EXTRA CREDIT ACTION (Not Washington State)

Let’s contact our state representatives and ask them to implement a law like the one in Washington. Their contact information is in the Resources section or here. The link to the Washington Charity Care Law is in the sample text below.

Here is a sample text.

“I am your constituent and I think it is horribly unfair that hospitals engage in aggressive bill collection techniques against those that have no way to pay. I want you to consider implementing a law like the one in Washington State, the Charity Care Law, that mandates financial assistance based on income level. Here is a link to that law, https://www.atg.wa.gov/charitycare#:~:text=The%20law%20ensures%20all%20Washingtonians,assistance%20depending%20on%20the%20hospital.

Thank you.”

EXTRA CREDIT ACTION 2

Let’s send an email to Bob Ferguson, Washington’s Attorney General and thank him for successfully retrieving so much money for low income Washingtonians from the Providence Hospital system.

You can send him an email here.

Here is a sample.

“Congratulations Attorney General Ferguson on successfully retrieving so much money from the Providence Hospital System for low income Washingtonians. The Charity Care Law in Washington should be enacted nationwide. Thank you.”

RESOURCES

Healthcare Advocacy (Us)

Website

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Find My Elected Officials

Contact the White House  https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

• By phone: (202) 224-3121

• By email: democracy.io

• https://www.usa.gov/elected-officials

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Organizations to Contact

National Nurses United Medicare4All

Physicians for a National Health Program

One Payer States

Healthcare Now

Reproductive Health

NARAL - Pro Choice America

Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion

Planned Parenthood

Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.

United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.

Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.

If you need financial help with an abortion try abortionfunds.org

Claims Denials and Appeals & What to Do

Appeal a Healthcare Decision

Appeal/Negotiate a Hospital Bill

Disinformation Management

Cybersecurity Infrastructure Security Agency

Library of Advice

Specific Advice

Save Democracy

Chop Wood, Carry Water by Jessica Cravens

RESISTBOT

Link to the RESISTBOT site to learn more

Link to Chop Wood, Carry Water RESISTBOT write up

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