Ruling resolves Ferguson’s case against last remaining defendant in charity care lawsuit against Providence and its debt collectors
SEATTLE — The Attorney General’s Office won a trial against debt collection agency Optimum Outcomes. Optimum is the last remaining defendant in Attorney General Bob Ferguson’s charity care lawsuit against Providence Health & Services, one of the nation’s largest health care systems, and its debt collectors.
King County Superior Court Judge Sean O’Donnell ruled that Optimum violated the Consumer Protection Act by violating the medical debt collection rights of Washington patients more than 82,000 times. Judge O’Donnell ordered Optimum to pay $10 per violation for a total penalty of $827,290, which will go to the state general fund. Optimum must also reimburse the Attorney General’s Office for the costs of bringing the case, which are estimated to exceed $400,000. The court will determine the exact amount in a future proceeding. Finally, Optimum must make reforms to come into compliance with Washington law.
Optimum Outcomes unlawfully collected payments from those patients without providing critical information about their rights when faced with medical debt. By excluding the legally required disclosures about financial assistance in its collection letters, Optimum Outcomes created barriers that kept patients who likely qualified for financial assistance from learning about and accessing help with their hospital bills.
“This legal victory resolves the largest charity care lawsuit in American history,” Ferguson said. “We delivered economic justice for Washingtonians in the form of corporate reforms and more than $160 million in direct payments, debt forgiveness and civil penalties. My team and I partnered with legislators, hospitals and patient advocates to protect Washingtonians from out-of-pocket hospital expenses they can’t afford — and we will make sure that Washingtonians receive these protections.”
On Feb. 2, the court found that Optimum Outcomes failed to provide the required charity care disclosures in 82,729 first written collection notices it sent to Providence patients, which violated the state’s Collection Agency Act and Consumer Protection Act.
Patients who were likely eligible for financial assistance but were sent to collections and paid for their care will receive refunds, including interest, as a result of the resolution with Providence. Patients who incurred debt when they were likely eligible for financial assistance will have their debt written off as a result of the resolution with Providence.
Assistant Attorneys General Audrey Udashen, Will O’Connor, Michael Bradley, Matthew Geyman, Lucy Wolf, Tad Robinson O’Neill and Robert Hyde, Paralegals Jen Killoren, Judy Lim, Matthew Hehemann and Joseph Drouin, and Legal Assistants Josh Bennett and Michelle Paules handled the case for Washington.
This is the latest of hundreds of consumer protection wins since Ferguson became Attorney General. Since January 2013, the office has filed 808 successful lawsuits under the Consumer Protection Act. In that same time, Ferguson has only lost two consumer protection cases — a case against Value Village and a challenge to the special dividend paid by Albertsons to its shareholders ahead of the company’s proposed merger with Kroger.
Providence debt collector illegally excluded disclosures in notices to patients
On Feb. 1, Providence entered into a legally enforceable agreement that requires the health system to provide $157.8 million in refunds and debt forgiveness to nearly 100,000 patients over unlawful medical charges to Washingtonians who likely qualified for free or reduced-cost hospital care.
In the summer of 2022, Ferguson expanded his lawsuit against Providence by adding the health system’s two debt collection agencies: Optimum Outcomes and Harris & Harris. On Feb. 21, Harris & Harris entered into a legally enforceable agreement with the Attorney General to pay $1 million and reform its practices, resolving that case and leaving Optimum Outcomes as the sole defendant for trial.
The court found that Optimum Outcomes failed to inform patients that they may be eligible for financial assistance, as required by state law. It also collected on medical debt without informing patients of their right to request specific information about that debt. Optimum also failed to provide a phone number for the hospital where patients received care, preventing many of them from learning about their financial assistance rights.
Both collection agencies entered into a contract with Providence in September 2019. The agreement allowed them to collect hospital debts on Providence’s behalf and act as its agents.
When sending a first collection notice, collection agencies must include:
Written notice that an individual may be eligible for charity care;
Contact information for the hospital; and
Notice that the patient has the right to request the hospital account number assigned to the debt, date of last payment, and an itemized statement stating whether the patient was found eligible for charity care, and, if so, the amount due after all charity care has been applied.
From February 2020 to July 2021, Optimum Outcomes sent 82,729 first written collection notices without these legally required disclosures, collecting more than $3.3 million from patients in the process. Optimum Outcomes earned more than $376,000 in commissions from Providence on those collection activities. Moreover, during that period — the entirety of the time it collected medical payments on behalf of Providence — Optimum Outcomes was not properly licensed to collect on medical debt in Washington.
Providence billed, aggressively collected from low-income patients
Ferguson filed his lawsuit against Providence in February 2022, accusing its affiliated hospitals of billing and aggressively collecting money from low-income Washingtonians without determining if they qualified for financial assistance.
Ferguson’s Consumer Protection investigation started in 2020, following complaints about collection practices at Swedish. It revealed Providence engaged in numerous practices between 2018 and 2022 that prevented patients from accessing financial assistance. Providence trained employees on aggressive and deceptive collection tactics. Their script included:
“Ask every patient every time” to pay outstanding medical costs;
“Don’t accept the first no;”
If a patient declines the first request, ask for partial payment;
Use phrasing that signals to patients “payment is expected.”
The lawsuit asserted that Providence knew many of its patients were likely eligible for financial assistance and not only failed to inform them, but also kept collecting payments from them. In fact, Providence sent thousands of patients it identified as “presumptively” qualified for financial assistance to debt collectors. Internal emails revealed Providence did this because it knew those patients were more likely to pay their bills if collection attempts continued.
Moreover, starting in 2019, Providence sent thousands of Medicaid patients to debt collectors. Medicaid enrollees are among the lowest income Washingtonians, and are deemed eligible for financial assistance under Providence’s own policies. Providence staff caught the issue early and raised concerns to leadership. In fact, according to internal records, one employee warned: “We are sending the poor to bad debt and not treating them the same as other patients.” Providence did not correct the problem for more than two years.
Even when Providence wrote off debt for patients it later determined to be “presumptively” qualified for financial assistance, the company kept them in the dark about those write-offs, and therefore their eligibility for future assistance.
In all, Ferguson asserts that Providence’s deceptive and unfair practices amounted to more than 100,000 violations of the state Consumer Protection Act.
The case against Providence is part of Ferguson’s Health Care Initiative. The resolution is the largest of four charity care cases handled by his office, resulting in more than $205 million in debt forgiveness and refunds for Washingtonians. Washington is one of 11 states with broad charity care protections and the only state to pursue any large-scale enforcement.
Ferguson’s three other charity care resolutions include:
PeaceHealth agreed to pay up to $13.4 million to more than 15,000 low-income patients, including $4.2 million in direct refunds and up to $9.2 million through a claims process.
CHI Franciscan provided $41 million in debt relief and $1.8 million in refunds, in addition to rehabilitating the credit of thousands of patients.
Capital Medical Center in Olympia paid at least $250,000 in refunds and provided more than $131,000 in debt relief to resolve Ferguson’s lawsuit filed in 2017.
Anyone who feels they are not receiving the financial assistance on their hospital bill they are entitled to should file a complaint with the Attorney General’s Office.
New law expands access to medical financial assistance
Before 2022, state law required hospitals to provide free or reduced-cost care to Washington families making up to 200% of the federal poverty level.
In March 2022, the Legislature passed an Attorney General Request bill strengthening Washington’s medical financial assistance law. It went into effect July 1, 2022. Ferguson worked with prime sponsor Rep. Tarra Simmons, D-Bremerton, and Reps. Eileen Cody, D-Seattle, and Nicole Macri, D-Seattle, on House Bill 1616. The new law expanded eligibility for financial assistance to more than one million Washingtonians and guaranteed free hospital care to an additional million Washingtonians.
Now, approximately half of all Washingtonians are eligible for free or reduced-cost hospital care. Washingtonians up to 300% of the federal poverty level are now eligible for free care at the state’s large health care systems and large, urban hospitals — representing approximately 80 percent of the licensed beds in the state. The bill also significantly increased medical financial assistance at the state’s smaller, more rural hospitals, with free care up to 200% of the federal poverty level and discounted care up to 400%.
Under the medical financial assistance law, hospitals are required to:
Provide notice of the availability of financial assistance both verbally and in writing;
Screen patients for eligibility before attempting to collect payment, and;
Only require patients to provide one income-related document to prove eligibility for financial assistance.
If a patient appears to be eligible for financial assistance, hospitals must suspend any collection attempts and give the patient a reasonable opportunity to apply.
For more information about Washington’s medical financial assistance law, including tools to see if you qualify.
IN OTHER STATE NEWS HEADLINES:
More than $55M paid to local governments this month from AG Ferguson opioid cases.
SEATTLE — Attorney General Bob Ferguson announced today that city and county governments in Washington state received more than $55 million this month in the latest payments from Ferguson’s litigation against companies that fueled the opioid crisis. The funds must be used to combat the opioid epidemic./WAAG
With billions of federal dollars at stake, state helps communities secure funding for infrastructure, innovation, jobs./ WA COMMERCE DEPT.
Public Works Board provides $2.4 million for emergency construction; paves way for more local infrastructure projects this summer/WA COMMERCE DEPT.
Cats and Competence: Teens Compete for State Mock Trial Championship this Weekend in Tacoma
March 20, 2024
Hundreds of high school students from across Washington will gather at the Pierce County Courthouse this weekend to compete in this year’s YMCA Mock Trial State Championship. For the first time, the competition moves to Tacoma after decades of being hosted in Olympia./WA COURTS
California, Québec and Washington agree to explore linkage.
OLYMPIA, WA –
The California Air Resources Board on behalf of the state of California, the Gouvernement du Québec, and the Department of Ecology representing the state of Washington each recognize that fighting climate change requires sustained collaboration by all governments. Today they are officially expressing their interest in the potential formation of a shared carbon market between the three jurisdictions./DOE
2) NEWS FROM OUR CONGRESSIONAL DELEGATION:
KILMER INTRODUCES LEGISLATION TO END BLOOD QUANTUM DISCRIMINATION AGAINST NATIVE AMERICANS IN BORDER LAW
WASHINGTON, D.C. – U.S. Representatives Derek Kilmer (WA-06) and Russ Fulcher (ID-01) introduced the Tribal Border Crossing Parity Act to redouble America’s efforts to end a half-century-old U.S. immigration policy which requires Native Americans to carry proof of their blood quantum, documents showing that they are at least 50 percent Native American, when exercising their treaty-protected right to freely cross between the U.S. and Canada./Press release issued 3/22/24
KILMER INTRODUCES LEGISLATION TO SPUR GROWTH IN OCEAN-BASED ENERGY, CREATE JOBS ON OLYMPIC PENINSULA
WASHINGTON, D.C. – U.S. Representatives Derek Kilmer (WA-06) and Dan Newhouse (WA-04) introduced the Blue Ocean Energy Innovation Act, bipartisan legislation to redouble America’s efforts to reassert the U.S. as the global leader in the research and development of ocean-based technologies, also known as blue energy technologies./press release issued 3/22/24
Cantwell, Murray, & Schrier Announce Federal Assistance Now Available to WA Cherry Growers
Lawmakers wrote a letter to Ag Secretary Vilsack last month urging him to expedite a disaster declaration/press release issued 3/19/24
Cantwell Statement on 10-Year Anniversary of Oso Landslide Tragedy/press release issued 3/21/24
At Press Conference Ahead of ACA Anniversary, Senator Murray Highlights Record ACA Enrollment and Slams Donald Trump and Republicans for Continuing to Push ACA Repeal./press release issued 3/21/24
At Senator Murray’s Recommendation, President Biden Nominates Judge Rebecca Pennell to Serve as U.S. District Court Judge in the Eastern District of Washington/press release issued 3/19/24
3) WORLD< NATION< BUSINESS
WORLD:
Global Community Must Stand as One, Work towards Legally Binding Treaty to End Plastic Pollution, Secretary-General Stresses, in Message for Zero Waste Day./UN PRESS RELEASE
At Security Council Briefing on Syria, Speakers Express Alarm Over Grave Situation in Country, Underscore Need for Sustained, Unrestricted Humanitarian Assistance
As the conflict in Syria entered its fourteenth year, the “tragic reality” was that developments are going in the wrong direction across all fronts, the Secretary-General’s Special Envoy for the country warned the Security Council today, as members echoed his urgent calls on Damascus and other actors to unblock the persisting political impasse./UN PRESS RELEASE
General Assembly Adopts Landmark Resolution on Steering Artificial Intelligence towards Global Good, Faster Realization of Sustainable Development
Delegates Also Observe International Day for Eliminating Racial Discrimination Worldwide, Stressing Importance of Reparations/UN PRESS RELEASE
Explanation of Vote Delivered by Ambassador Linda Thomas-Greenfield on a UN Security Council Draft Resolution on the Situation in the Middle East/USUN
United Nations General Assembly Adopts by Consensus U.S.-Led Resolution on Seizing the Opportunities of Safe, Secure and Trustworthy Artificial Intelligence Systems for Sustainable Development./US STATE DEPT.
NATIONAL:
Consensus Adoption of U.S.-Led Resolution on Artificial Intelligence by the United Nations General Assembly./US STATE DEPT.
Statement from President Joe Biden on Nearly $6 Billion in Student Debt Cancellation for 78,000 Public Service Workers/WH
Hicks Again Makes Case for Strengthening Industrial Base, Eliminating Continuing Resolutions/DOD
Justice Department, Federal Trade Commission, Consumer Financial Protection Bureau and Department of Housing and Urban Development Jointly Issue Resource on Protections for Rental Housing Applicants and Tenants/DOJ
U.S. Department of Education’s Office for Civil Rights Announces Resolution Addressing Responses to Harassment Based on Race, Sex, and Disability and to Antisemitic Harassment in Park City School District in Utah./DEPT OF EDUCATION
BUSINESS:
Federal Court Enters $9.9M Penalty and Injunction Against Man Found to Have Caused Thousands of Unlawful Spoofed Robocalls/DOJ
Justice Department Sues Apple for Monopolizing Smartphone Markets.
Apple’s Broad-Based, Exclusionary Conduct Makes It Harder for Americans to Switch Smartphones, Undermines Innovation for Apps, Products, and Services, and Imposes Extraordinary Costs on Developers, Businesses, and Consumers/DOJ
Confiscating Property Won’t Lower Prices for Americans
The Biden Administration's proposal to abuse “march-in rights” will diminish consumer choice and American innovation./ US CHAMBER OF COMMERCE
FTC Files Amicus Brief in Asthma Inhaler Patent Dispute
Commission seeks to address Teva’s patent abuse to promote affordable drugs, generic competition/FTC
Applications for USDA Urban Agriculture and Innovative Production Grants Due April 9/USDA
WASHINGTON, March 19, 2024 – The U.S. Department of Agriculture (USDA) is accepting applications for grants to support urban agriculture and innovative production. Applications for USDA’s Urban Agriculture and Innovative Production grants are due April 9, 2024 via grants.gov.
IN FOCUS & LOCAL MEETINGS
IN FOCUS: CONSUMER ALERT: IVF treatment protected under Washington’s robust reproductive health care laws
AG Ferguson assures patients, providers in wake of Alabama Supreme Court decision deeming frozen embryos ‘children’
OLYMPIA — Attorney General Bob Ferguson issued the following statement today, assuring patients and providers across Washington that the state’s strong protections for reproductive freedom include access to assisted reproduction, including in vitro fertilization (IVF).
Ferguson’s consumer alert is a response to a recent decision from the Alabama Supreme Court, which ruled that embryos created through IVF are “children” for the purposes of that state’s wrongful-death law. The decision caused an abrupt pause in fertility services across Alabama and raised concerns about potential implications for standard practices in fertility treatment, such as freezing or destroying embryos created for purposes of IVF.
“IVF and other forms of assisted reproduction are protected under Washington law,” Ferguson said. “Washington voters passed the Reproductive Privacy Act three decades ago to guarantee protections for reproductive freedom — full stop. While attacks on these fundamental rights continue across the country, Washington remains a refuge during this public health crisis. We will not stop fighting to preserve access to the full range of vital reproductive health care services, including the right to seek an abortion.”
Washington’s Reproductive Privacy Act was approved by voter initiative in 1991, codifying the right to choose into state law. At the time supporters warned of potential threats to Roe v. Wade, the landmark U.S. Supreme Court decision that recognized a federal constitutional right to seek abortion care. Washington voters decided to protect reproductive rights in our state even if federal protections went away.
In the wake of the U.S. Supreme Court’s Dobbs decision overturning Roe, upholding state laws like Washington’s Reproductive Privacy Act is more critical than ever.
Washington’s law states: “The sovereign people hereby declare that every individual possesses a fundamental right of privacy with respect to personal reproductive decisions.” Additionally, the state cannot “discriminate against the exercise of these rights in the regulation or provision of benefits, facilities, services, or information.”
Additionally, in 2023, the Legislature enacted Washington’s Shield Law, further strengthening protections for reproductive health care services, patients and providers. The new law states that it is “the public policy of Washington to protect” the provision of gender-affirming treatment and reproductive health care services — which includes a broad range of care, including assisted reproduction such as IVF. More information about the Shield Law is available at the Attorney General’s website.
In short, it is public policy in Washington that patients have access to the full range of reproductive health care — including assisted reproduction, such as IVF — and their decisions about that care are made privately between them and their health care providers, without government interference.
IN FOCUS: DNR Forest Health Treatments Provide New Revenue for Schools.
Forest Health Revolving Account invests in forest health, risk reduction and protection while supporting statewide services
An innovative program run by the Washington Department of Natural Resources to restore forest health will distribute $6,551,212 of funds to state trust beneficiaries to support statewide services including K-12 Schools.
DNR generates more than $250 million each year through the management of trust lands, which are required to generate revenue to support schools, colleges, and critical local services across Washington state. That revenue comes from sustainable forest management, agricultural leases, clean energy leases, and commercial real estate leases.
The Forest Health Revolving Account was created to support less financially productive trust lands, largely in Eastern Washington, by mitigating risks posed by insect damage, wildfires, and disease. The account allows DNR to perform forest health treatments that reduce risks posed to the forests and surrounding communities.
“Our Forest Health Revolving Account is just one example of our agency’s commitment to not only the people of Washington, but also to responsible management of our forests, and support of our public services statewide” said Commissioner of Public Lands Hilary Franz. “This distribution is a win for our beneficiaries, and the investments in forest health are a win for the surrounding communities and our trust lands.”
Revenue garnered from forest health treatments goes back to the Forest Health Revolving Account to fund future treatments. Per RCW 79.64.130, any unobligated amount exceeding $10 million at the end of the calendar year is distributed to beneficiaries. 2023 marks the 3rd distribution to beneficiaries since the start of the program in 2017. For calendar year 2022, DNR distributed $9,571,200 to schools and universities. The agency distributed $5,067,781 in 2021.
ref. https://www.dnr.wa.gov/news/dnr-forest-health-treatments-provide-new-revenue-schools
CLALLAM COUNTY MEETINGS:
Work session of the Clallam County commission for 3/25/24
https://www.clallamcountywa.gov/AgendaCenter/ViewFile/Agenda/_03252024-1138
Clallam County Commission meeting for 3/26/24
https://www.clallamcountywa.gov/AgendaCenter/ViewFile/Agenda/_03262024-1140
* There's a Port of Port Angeles Commission meeting scheduled for 3/26/24, but no agenda was posted on webpage, or time of meeting during publishing this week's edition.
City of Sequim Council meeting for 3/25/24
https://sequimwa.civicweb.net/Portal/MeetingInformation.aspx?Id=112
City of Forks Council meeting for 3/25/24
https://forkswashington.org/wp-content/uploads/2024/03/Agenda-20240325.pdf
Clallam PUD meeting for 3/25/24
https://go.boarddocs.com/wa/clallampud/Board.nsf/Public
JEFFERSON COUNTY MEETINGS:
Jefferson County Commission meeting for 3/25/24
https://test.co.jefferson.wa.us/WeblinkExternal/0/edoc/5192264/032524A.pdf
Port of Port Townsend Commission meeting for 3/27/24
https://portofpt.com/wp-content/uploads/2024-03-27-CommMtg-Agenda.pdf
Weekly devotional
BIBLE VERSE: James 1:12 (New International Version)
Blessed is the one who perseveres under trial because, having stood the test, that person will receive the crown of life that the Lord has promised to those who love him.
Weekly Bible Lesson:
How the Corinthians Became Christians
Before Jesus returned to Heaven, He gave the apostles the Great Commission. He commanded: “Go ye into all the world, and preach the Gospel to every creature. He that believeth and is baptized shall be saved; but he that believeth not shall be damned” (Mark 16:15-16). In the book of Acts, we can read how the apostles carried out the Great Commission.--TFTW
https://truthfortheworld.org/how-the-corinthians-became-christians
Free bible studies (WBS)
https://www.worldbibleschool.org/
Learn English using the bible as text (WEI)
http://www.worldenglishinstitute.org/
(Join us in worship every Sunday starting at 10:30AM Church of Christ)
1233 E Front St, Port Angeles, WA 98362
The Chosen: About the life of Christ
https://watch.angelstudios.com/thechosen
THIS WEEK'S VIDEOS:
DEBATE: Is the TikTok Bill a Trojan Horse for Government Censorship?
One of the hottest questions happening online and at the dinner table right now is: What do we do about TikTok? The app has 150 million active users in the United States. The average American spends 82 minutes a day on the platform. That’s TRIPLE the time the average user spends on Snapchat or Twitter and twice what the average user spends on Instagram or Facebook. It’s so addictive, but why? Did you know that China has stated that the algorithm running TikTok is one of its MAJOR national security assets? A Chinese propaganda analyst has said, “The one who wins the platform [TikTok] wins the world.” We can all agree that something has to be done about TikTok ... but is the recent bill from Congress the answer?
Glenn reveals the full text of the bill to let you decide for yourself and brings in two congressmen he respects to help him come to a conclusion. Rep. Chip Roy (R-Texas) and Rep. Thomas Massie (R-Ky.) are both strong champions of the Constitution but on opposite sides of the House’s recent TikTok bill. Roy was one of the bill’s lead cosponsors, and Massie has called the bill a “Trojan Horse.” After hearing both arguments, Glenn gives his final thoughts. Yes, we’re in a war with China, but we’re also at war with communism and fascism and oligarchs ... in our own country! Can we repair this country by giving more power to the government?
https://www.youtube.com/watch?v=PgInAm6YOW8
Sunday Worship 3/17/2024- FOUR LAKES C. of C.
https://www.youtube.com/watch?v=KIsRWJuuQyw
NIGHT OWL COMICS
https://pjrnightowlcomics.blogspot.com/
The Port Angeles Globe is a weekly Publication, every Saturday-- Publisher, Peter Ripley
