OLYMPIA — Attorney General Bob Ferguson today filed a lawsuit against Capital Medical Center in Olympia, alleging it repeatedly violated Washington’s Consumer Protection Act by withholding charity care from thousands of low-income patients.
The lawsuit alleges that management at Capital Medical Center, a for-profit hospital, created a culture that elevated aggressive collection over access to charity care. Capital trained staff to pressure patients to pay for their treatment upfront without screening patients for charity care eligibility or providing notice of the availability of charity care.
According to the complaint, Capital’s focus on aggressive collection came from its management. Capital’s former CEO, Jim Giest, called collection and registration staff members the emergency department’s “money makers.” He said in a 2012 meeting that the hospital needed to “get something out of” every patient and told staff to not let uninsured patients “leave without paying anything.”
Because of these coercive practices, thousands of charity care-qualified patients were forced to pay for their treatment upfront, incur medical debt or defer important medical care.
“Capital’s unlawful collections practices prevented thousands of Washington’s neediest patients from receiving charity care,” said Ferguson. “I am committed to ensuring that all Washingtonians, regardless of income, have access to affordable care.”
Capital is a 110-bed, for-profit hospital owned by RCCH HealthCare Partners, which owns 17 hospitals in 12 states.
Washington state law requires all hospitals — for-profit and non-profit, public and private — to provide charity care to individuals who are near the federal poverty level. Hospitals are required to:
Provide notice of the availability of charity care both verbally and in writing;
Screen patients for charity care eligibility before attempting to collect payment, and;
Only require patients to provide one income-related document to prove charity care eligibility.
In the lawsuit, filed in Thurston County Superior Court, Ferguson alleges that Capital violated all of these requirements by training its staff to aggressively demand payment from patients without screening them for charity care eligibility or informing them of their charity care rights. Capital also required that patients produce multiple forms of income documentation to apply for charity care.
In a letter to patients who did apply, the hospital required patients to provide up to eight documents proving income, including written documentation from income sources, a current credit report and three pay stubs.
Capital trained its staff to present only upfront payment, payment plans and medical credit cards as payment options and only to provide information about charity care to patients who explicitly requested it.
A Capital patient reported that during registration for a scheduled procedure, a staff member demanded she pay upfront and in full. The staff member indicated that the procedure would not go forward unless the patient either paid the full amount or signed up for a medical credit card offered through Capital.
The patient signed up for the credit card because she could not afford to pay for her treatment upfront and she felt that she would not receive care otherwise. The patient received no information about charity care during this interaction.
Capital’s Patient Access Department “cleared” uninsured patients before scheduling them for surgery. During clearance, staff members informed patients of the cost of their treatment, assessed their ability to pay this amount and attempted to reach a negotiated payment arrangement.
The complaint alleges that in 2012, an uninsured, unemployed patient attempted to schedule a surgery with Capital. Instead of providing a charity care application after the patient offered to pay through a payment plan, the Patient Access Director decided they “will not move forward with this patient.”
When Capital’s financial counselor informed the patient that Capital would not schedule her surgery, she offered to pay a down payment. The financial counselor explained that Capital “would not move forward without payment in full,” even after the patient requested more information about her payment options.
During pre-treatment collection calls, Capital threatened to cancel medical appointments and surgeries if patients did not agree to make upfront payments. They did not screen patients for charity care eligibility during this process.
A patient reported that, in 2016, a financial counselor called asking the patient how she would like to pay for an upcoming treatment. The financial counselor offered her two payment options: pay in full and receive a 25 percent discount, or pay 50 percent down with a payment plan for the remainder. The counselor indicated that she had 48 hours to commit to one of these two options or her appointment would be cancelled.
The counselor did not give this patient any information about charity care or screen her for charity care eligibility during this call.
In a subsequent call, the patient specifically requested information about charity care. Capital’s financial counselor informed her that although she could request a charity care application at the hospital on the date of her treatment, she needed to commit to making a payment in advance because “Capital does not pre-approve patients for financial assistance.”
Capital provided cash bonuses and other incentives to staff who met collection targets. In an email to a team of emergency room registrars, Capital’s Patient Access Director emphasized collecting payment from “every patient, every time.”
Capital required staff members to attempt to collect a deposit from every patient in the emergency room, even those in hospital beds and gowns, regardless of their ability to pay. Capital continued to demand $200 deposits from uninsured patients even after it screened them for charity care.
Capital’s aggressive collection practices reduced the amount of charity care it provided. Between 2012 and 2015, Capital consistently provided less charity care than the regional average, often less than 1 percent of its revenue.
For instance, in 2014, hospitals in Southwest Washington provided an average of about 6 percent of their revenue in charity care. Capital provided just .37 percent of its adjusted revenue in charity care that year, leaving Capital with the lowest charity care rate in both the region and in Washington State.
Ferguson’s lawsuit seeks to ensure that Capital Medical Center provides patients with notice of their charity care rights before requesting payment, properly screens them for charity care eligibility and ceases its aggressive collection practices. It also seeks restitution for low-income patients harmed by the hospital’s practices, in addition to civil penalties.
The state Consumer Protection Act allows for a civil penalty of up to $2,000 per individual violation. Capital’s practices impacted thousands of patients, limiting their access to charity care and financial assistance.
BACK TO SCHOOL 2017
U.S. Department of Education Announces Hurricane Flexibility GuidancePRESS RELEASE ISSUED 9/ 22/ 17 (link source)
As part of its ongoing work to aid hurricane relief efforts, today the Department of Education released new non-regulatory guidance to help Department grantees and program participants remove barriers to restoring teaching and learning environments and to expediting the recovery process for all those impacted by the recent hurricanes.
"For children of affected families, returning to school can provide stability in a time of upheaval as they reconstruct their lives," said U.S. Secretary of Education Betsy DeVos. "The Department will continue to provide whatever flexibility and support it can to help ensure stakeholders have the resources they need to get these students back into the classroom as quickly as possible."
The newly released guidance provides support to state and local educational agencies, Bureau of Indian Education-funded schools, postsecondary institutions and other Department grantees and program participants in a variety of ways, while also covering topics specific to program areas.
Examples of such supports include:
Flexibility on reporting deadlines, timelines for grant-funded activities and maintenance of fiscal effort or matching requirements.
Potential alternatives and strategies for providing program services after disruption.
Suggested methods for ensuring continuity of services and communication with program participants.
To view the Non-Regulatory Guidance on Flexibility and Waivers for Grantees and Program Participants Impacted by Federally Declared Disasters.
All interested parties are urged to contact the Department of Education with any requests for assistance beyond the scope of the documents released today. The Department is committed to collaborating with impacted parties, as well as other federal, state and local agencies to remove barriers and expedite the work necessary to respond to and recover from the recent hurricanes.
It is important to emphasize that this guidance addresses only federal requirements and flexibilities and that only state and local officials can address state and local requirements and flexibilities.
Department of Education Issues New Interim Guidance on Campus Sexual Misconduct
PRESS RELEASE ISSUED 9/ 22/ 17 (link source)
Washington — Building on her remarks from September 7, 2017, regarding the Department's commitment to protecting all students from discrimination, today U.S. Secretary of Education Betsy DeVos announced the release of a new interim Q&A for schools on how to investigate and adjudicate allegations of campus sexual misconduct under federal law.
"This interim guidance will help schools as they work to combat sexual misconduct and will treat all students fairly," said DeVos. "Schools must continue to confront these horrific crimes and behaviors head-on. There will be no more sweeping them under the rug. But the process also must be fair and impartial, giving everyone more confidence in its outcomes."
In the coming months, the Department intends to engage in rulemaking on Title IX responsibilities arising from complaints of sexual misconduct. The Department will solicit comments from stakeholders and the public during the rulemaking process, a legal procedure the prior administration ignored.
In the interim, the newly-released Q&A on Campus Sexual Misconduct explains the Department's current expectations of schools, and the Department will continue to rely on its Revised Sexual Harassment Guidance, which was informed by a public comment process and issued in 2001, as well as the Dear Colleague Letter on Sexual Harassment issued on January 25, 2006.
"In the coming months, hearing from survivors, campus administrators, parents, students and experts on sexual misconduct will be vital as we work to create a thoughtful rule that will benefit students for years to come. We also will continue to work with schools and community leaders to better address preventing sexual misconduct through education and early intervention," DeVos added.
The Department of Education is also withdrawing the Dear Colleague Letter on Sexual Violence dated April 4, 2011, and the Questions and Answers on Title IX Sexual Violence dated April 29, 2014. The withdrawn documents ignored notice and comment requirements, created a system that lacked basic elements of due process and failed to ensure fundamental fairness.
DeVos concluded, "As I said earlier this month, the era of rule by letter is over. The Department of Education will follow the proper legal procedures to craft a new Title IX regulation that better serves students and schools."
Related news release from our Congressional delegation in cased you missed it: Senators Murray, Cantwell, Colleagues Urge Education Secretary Betsy DeVos to Uphold Protections for Sexual Assault Survivors, Invest in Civil Rights Office
DEPT OF EDUCATION BLOG: Education Opportunity Migrates to Nation’s Farmworkers
blog posted on 9/ 20/ 17 (link source)
If you’re a high school student in rural America, it’s not always easy to get to school. You may have to travel a lot farther than you would in the city. But what if you live in a rural area and also need to travel with your family to go to work on a farm? How would you get to high school? Could you go to college?
The U.S. Department of Education’s (ED) Office of Migrant Education (OME) recognizes the challenges that migrant families face and oversees two competitive grants that provide high school and college opportunity for migrant and seasonal farmworkers. The High School Equivalency Program (HEP) funds selected two-year community colleges, four-year universities, and nonprofit community organizations that provide high school equivalency classes tailored to the needs of these students. The College Assistance Migrant Program (CAMP) grants money to community colleges and universities to offer migrant students their first year of post-secondary education.
“These HEP and CAMP programs change lives for many generations,” said Lisa Ramirez, director of both OME and the Office of School Support and Rural Programs, as well as the daughter of migrant workers and a former migrant worker herself. “To my knowledge, there is no other program that is set up the way HEP and CAMP are set up, and the support activities that we provide to our students are unique.”
Nationwide in 2016, 2,405 migrant and seasonal farmworker students earned a high school equivalency diploma through HEP, and 1,475 migrant and seasonal farmworkers completed their first year of college through CAMP.
This past August, OME held its annual HEP/CAMP Directors Meeting, at ED headquarters. Approximately 130 grantees attended the two-day conference to receive OME technical assistance and collaborate. The agenda featured two student speakers, one of whom graduated under a HEP grant and one who is studying in a CAMP-funded college program. (read the full article from the link source)
Secretary DeVos Approves Massachusetts' ESSA Plan
PRESS RELEASE ISSUED 9/ 21/ 17 (link source)
U.S. Secretary of Education Betsy DeVos today announced the approval of Massachusetts' consolidated state plan under the Every Student Succeeds Act (ESSA).
"I continue to be heartened by the ways in which states have embraced the flexibility afforded to them under ESSA," said Secretary DeVos. "I want to thank Acting Commissioner Jeff Wulfson, Governor Charlie Baker and all the stakeholders that contributed to Massachusetts' plan. This plan also serves as a testament to the leadership of the late Commissioner Mitchell Chester, who remains greatly missed. I look forward to seeing how these words on paper translate to classroom action that meets the unique needs of the students across the commonwealth."
Allowing states more flexibility in how they deliver education to students is at the core of ESSA. Each state crafted a plan that it feels will best offer educational opportunities to meet the needs of the state and its students. The following are some of the unique elements from Massachusetts' plan:
Champions strategies to help transform the lowest-performing schools and districts which includes state and local partnerships, empowering school and district innovation and bold intervention authority.
Measures the percentage of juniors and seniors in high school who complete broad and challenging coursework—including Advanced Placement, International Baccalaureate and honors courses—in order to incentivize participation in rigorous coursework and to reduce equity gaps among student subgroups enrolled in advanced courses.
"Massachusetts is proud of the achievements of our K-12 student population, but like most other states, we still have a lot of work ahead to close persistent achievement gaps," said Commissioner Jeff Wulfson. “"Our ESSA state plan provides a framework for accountability and targeted assistance and builds on a system that has helped improve schools for Massachusetts students. We appreciate the support we've received from Secretary DeVos and her staff and look forward to working in partnership with them."
WORLD AND NATIONAL BRIEFS, from Reuters.
North Korea bolsters defenses after flight by U.S. bombers as rhetoric escalates
SEOUL/BEIJING (Reuters) - North Korea has boosted defenses on its east coast, a South Korean lawmaker said on Tuesday, after the North said U.S. President Donald Trump had declared war and that it would shoot down U.S. bombers flying near the peninsula.
France's Macron says euro zone needs its own budget, a finance minister
PARIS (Reuters) - French President Emmanuel Macron on Tuesday reaffirmed that he wanted the euro zone to have its own budget and finance minister, adding that it was key to ensure the stability of the single currency union and to weather economic shocks.
'Put people above debt,' Puerto Rico official urges amid Maria's devastation
SAN JUAN, Puerto Rico (Reuters) - San Juan’s mayor urged the United States on Tuesday to prioritize “people above debt” as it helps rebuild from the devastation of Hurricane Maria, after President Donald Trump said that the island’s crippling debt “must be dealt with.”
NATIONAL
Obamacare repeal on the ropes as pivotal Republican rebuffs Trump
WASHINGTON (Reuters) - U.S. Senator Susan Collins rebuffed intense lobbying from fellow Republicans and the promise of money for her state in deciding on Monday to oppose - and likely doom - her party’s last-ditch effort to repeal Obamacare.
Trump ramps up NFL fight, calls for ban on kneeling during anthem
WASHINGTON (Reuters) - U.S. President Donald Trump ramped up with his fight with the National Football League on Tuesday, calling on the popular league to ban players from kneeling in protest at games while the U.S. national anthem is played.
Ex-N.Y. state senate leader's conviction is vacated
NEW YORK (Reuters) - A U.S. appeals court on Tuesday threw out the conviction of former New York state Senate Majority Leader Dean Skelos, citing a recent U.S. Supreme Court decision that narrowed the conduct that can sustain federal corruption charges.
Daily Bible Verse: For we know Him who said, “Vengeance is Mine, I will repay,” says the Lord. And again, “The Lord will judge His people.” It is a fearful thing to fall into the hands of the living God.
Hebrews 10:30-31 NKJV
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