Nonprofit hospital chain in Washington to refund $13.4 million to low-income patients
A non-profit chain of hospitals in Washington will refund up to $13.4 million to more than 15,000 low-income patients who used their services after a state Attorney General’s Office investigation found those patients should have qualified for financial assistance.
Low-income patients at five PeaceHealth hospitals in Washington including Bellingham, Friday Harbor, Longview, Sedro-Woolley and Vancouver were affected, according to a news release from Attorney General Bob Ferguson’s office Monday.
“PeaceHealth failed to screen patients for financial assistance eligibility prior to attempting to collect payment, failed to meaningfully disclose the availability of financial assistance, and collected payment from patients who it knew were likely eligible for financial assistance without disclosing their eligibility,” the news release says.
PeaceHealth uses a “tool that uses public data and analytics to predict which patients may be eligible for financial assistance,” the AGO said. “However, instead of notifying patients who it found were likely eligible, PeaceHealth billed them for their care.”
Many of those paid for their care after being billed, unaware that they were entitled to financial assistance. PeaceHealth wrote off bills that were unpaid or partially paid, but still did not inform patients that they were eligible.
Some impacted patients will receive checks sent in the mail after $4.2 million was set aside for direct refunds. That amount includes full restitution, plus interest.
More than 4,500 patients will receive an average payment for over $900. Nearly 50 patients will receive refunds totaling more than $5,000, and eight patients will receive more than $10,000.
A claims process will refund approximately 11,000 patients who were “also likely eligible for help on their medical bills,” the AGO said. PeaceHealth is required to refund $9.2 million for those claims, including $900,000 in interest. Patients who file claims will receive full restitution plus interest.
The AGO will send letters explaining the resolution and refund process to those who qualify, the news release says.
Patients who have questions should contact PeaceHealth at 877-314-2011.
Those who feel they have not received financial assistance they are entitled to should file a complaint with the AGO, the office said.
As part of the consent decree filed in Whatcom County Monday, PeaceHealth must screen patients for eligibility as well as notify patients of financial assistance. They must also “provide patients with a financial assistance application if the patient appears to be eligible after screening, or if the patient requests one,” and “refrain from billing or attempting to collect payment until the patient’s financial assistance application is processed.”
PeaceHealth will have to pay an additional $2 million to the AGO to reimburse the cost of the investigation that was first opened in 2020.
