By Jay Hancock and Elizabeth Lucas September
10, 2019
Gov.
Ralph Northam and the president of the University of Virginia committed to
changing UVA Health System’s collections practices a day after Kaiser Health
News detailed its aggressive and widespread
pursuit of former patients for unpaid medical bills.
Over six
years, the state institution filed 36,000 lawsuits against patients seeking a
total of more than $106 million in unpaid bills, a KHN analysis finds.
At the
same time, the health system announced the departure of CEO Pamela
Sutton-Wallace, who will leave in November to join New York-Presbyterian
Hospital as a senior vice president.
Her
exit “is in no way related” to the billing and collections problems, James
Ryan, UVA’s president, said in a message to employees Tuesday.
UVA
sued former patients for unpaid bills more than 36,000 times over six years,
seeking repayment of over $106 million and often pushing families into onerous
payment plans or bankruptcy, according to KHN’s investigation, published
with The Washington Post.
Both
Ryan and Northam expressed ignorance about UVA practices that were an open
secret in Charlottesville, with hundreds of medical lawsuits often filed in a
week.
Northam
“was only just made aware of these practices,” said spokeswoman Alena Yarmosky,
adding that he “is not involved” in day-to-day university operations.
Northam,
a pediatric neurologist who oversees UVA’s board and often speaks about the
need for affordable health care, said he is “absolutely concerned” about what
the health system has been doing.
“I am
glad to hear that UVA Health System is in the process of changing their
policies and practices,” Northam said Tuesday in a prepared statement. He
declined to offer remedies or agree to an interview.
Ryan
said in a tweet late Monday that he had asked Sutton-Wallace last month to look
into collection and litigation practices. KHN informed UVA of its findings Aug.
1.
Fixing
the problem “is complicated,” in part because “we are legally obligated as a
state agency to collect debts,” he said. “But we have discretion within those
legal constraints to make our system more generous and more humane.”
Ryan
and Sutton-Wallace also declined interview requests through spokesmen.
The
health system is making a “comprehensive review” of its indigent care and
financial assistance policies and will announce changes by the end of the week,
said spokesman Eric Swensen.
“I
learned about our aggressive billing and collection practices within the
medical center a little over a month ago,” Ryan said in his tweet. “Part of
striving to be both a great and good university is honestly facing problems you
encounter and doing what you can to address them.”
The
departure of Sutton-Wallace, named CEO five years ago, leaves the prestigious
medical system with two top vacancies. Richard Shannon, executive vice
president for health affairs, left in May.
UVA
Health System, which is taxpayer-supported and state-funded, is the latest
medical center to face withering scrutiny over patient collections as insurance
coverage continues to leave consumers financially vulnerable — despite passage
of the Affordable Care Act in 2010.
High-deductible
health plans, unaffordable premiums, short-term insurance that doesn’t cover
preexisting illness and narrow provider networks all expose patients to
unexpected bills of thousands or hundreds of thousands of dollars.
In
recent months, journalists and academics have exposed collections practices in Baltimore, Memphis and New Mexico and at another Virginia hospital.
A top federal health care regulator made a pointed reference to the coverage in
a speech to hospital executives Tuesday.
“We are
learning the lengths to which certain not-for-profit hospitals go to collect
the full list price from uninsured patients,” Medicare administrator Seema
Verma said in a speech before members of the American Hospital Association.
“These hospitals are referring patients to debt collectors, garnishing wages,
placing liens on property and even suing patients into bankruptcy.”
Phil
Galewitz and Emmarie Huetteman contributed to this report.
Jay
Hancock: jhancock@kff.org,
@JayHancock1
Elizabeth
Lucas: elucas@kff.org,
@eklucas
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