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Washington AG sues Providence, Swedish hospitals for failing to ensure patients receive charity care

The hospitals failed to notify patients they were eligible for assistance and aggressively sought payment from low-income patients, the lawsuit alleges.

KING COUNTY, Wash. — The Washington Attorney General is suing five Swedish hospitals and nine Providence-affiliated facilities for allegedly failing to ensure low-income Washington residents received discounts they were legally entitled to. 

Bob Ferguson's office also alleged the hospitals "aggressively collect[ed] money" from eligible low-income patients. 

Washington's charity care law requires hospitals to provide free and discounted inpatient and outpatient care to eligible residents, according to the Washington State Hospital Association. Hospitals are responsible for maintaining their own charity care programs. 

Ferguson's lawsuit alleges the hospitals committed thousands of Consumer Protection Act violations, including training employees to "aggressively collect payment" even from patients eligible for discounts and instructing employees to use a script that implied patients were expected to pay for their care. 

The lawsuit alleges Providence instructed employees to not "accept the first no" from patients. The hospitals allegedly trained staff to encourage employees to continue pressing patients for payment even if they say they aren't able to pay. Employees are allowed to discuss financial assistance if patients decline to set up a payment plan.

Ferguson also alleged the hospitals failed to notify patients they were eligible for charity care even after determining they qualified. Washington law requires hospitals provide notice that charity care is available and screen patients for charity care eligibility before attempting to collect payment.

The facilities are also accused of sending more than 54,000 patient accounts to debt collection that were eligible for financial assistance.

In a November deposition, a Providence financial executive admitted that hospitals continue to send patients eligible for financial assistance to collections, according to the AG's office. Ferguson alleges the hospitals have been failing to ensure eligible patients receive charity care since 2018.

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“Hospitals cannot deceive Washingtonians about their legal right to access medical financial assistance. They must follow the law, and ensure low-income patients have access to the resources they need," Ferguson said.

In a statement, Providence called the charges "inaccurate and unfair" and argued their charity care practices "comply with, and in many instances exceed, the requirements of Washington's Charity Care Act." 

The hospital system acknowledged the AG's office first reached out with concerns about their charity care practices in 2020, saying the company "cooperated fully and in good faith."

"That is why it is inconceivable that the AG has chosen now to file this complaint, which runs counter to the facts we provided to his office," the statement reads.

The company said it looked forward to defending its practices in court. Read Providence's full statement here.

The lawsuit is full write-offs of medical debts and refunds, plus interest, for patients who were eligible for medical assistance but did not receive it, in addition to millions of dollars in civil penalties.  

Anyone who paid for services or is in collections from a Providence or Swedish hospital and believed they may be eligible for charity care is asked to contact the Attorney General's Office Investigator Bau Vang at 206-516-2989 or by email at bau.vang@atg.wa.gov.

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