Atrium Well being, the state’s prime collector of medical debt in recent times, has quietly stopped suing sufferers for unpaid medical payments.
The change was praised by critics who’ve lengthy stated it’s not proper for a publicly chartered, multibillion-dollar, nonprofit hospital to take sufferers to court docket for medical prices which might be typically out of their management.
The Charlotte-Mecklenburg NAACP has been advocating for Atrium to finish the apply for at the least a decade, stated president Corine Mack.
“When individuals are sick, the very last thing they have to be involved about is whether or not they’ll be sued for merely making an attempt to get the assistance they should keep alive,” Mack stated. “Consider how hypocritical that’s for a nonprofit to be suing folks.”
Mack stated she was inspired that Atrium was lastly doing the fitting factor, however she famous that the change received’t assist lots of of sufferers who nonetheless have judgments in opposition to them and liens on their properties.
Courtroom data reviewed by The Charlotte Ledger/NC Well being Information present Atrium continues to be pursuing cost in these instances.
In an emailed response to questions, Atrium stated it stopped taking sufferers to court docket for unpaid payments in November 2022 as a part of its “journey in making well being care extra reasonably priced” and upfront of its mixture with Midwest-based Advocate Aurora Well being.
“Atrium Well being is repeatedly evaluating how we are able to finest serve our sufferers and guarantee fairness in entry to high-quality take care of all members of our communities,” Atrium stated. (Learn the total assertion.)
Atrium made no public announcement in regards to the change, and it went largely unnoticed till now.
Most hospitals don’t take sufferers to court docket
From 2017 to June 2022, Atrium filed 2,482 lawsuits in opposition to sufferers for medical debt – greater than some other N.C. hospital, in line with an August report from Duke College Regulation College and the workplace of State Treasurer Dale Folwell.
Even making an allowance for Atrium’s standing because the state’s largest hospital system, it was nonetheless answerable for a disproportionate variety of instances, the examine confirmed: Atrium filed 42 p.c of the state’s bill-collection lawsuits and is house to 14 p.c of the state’s hospital beds.
A majority of U.S. hospitals – together with Novant Well being, Duke Well being and UNC Well being in North Carolina – don’t file lawsuits in opposition to sufferers over unpaid medical payments.
People who do have come beneath fireplace in recent times as medical debt has change into an rising burden for Individuals. Greater than half of U.S. adults stated they’ve gone into debt due to medical or dental payments, in line with a KFF ballot.
It’s an particularly acute drawback in North Carolina, the place about one in 5 households has medical debt in collections, in line with information compiled by The City Institute. That compares to a nationwide common of 13 p.c.
“For a while, we’ve had a bunch of residents coming to us to complain about how their credit score was being ruined and the way they had been going into debt due to medical funds,” stated George Dunlap, chair of the Mecklenburg County commissioners. “To know that Atrium is now not doing that actually lifts the burden for these being put in that place.”
Beneath-the-radar change
Atrium initially declined to reply questions in regards to the new coverage, however then reconsidered and despatched its assertion Friday afternoon.
It’s unclear if the brand new coverage was voted on by the Charlotte-Mecklenburg Hospital Authority Board of Commissioners, the general public physique that oversees Atrium Well being.
Board chair Angelique Vincent-Hamacher didn’t return a message asking for remark. William C. Cannon Jr., chair of the board’s finance committee, stated all media requests needed to undergo hospital communications.
The billing and collections coverage posted on Atrium’s web site signifies it was revised on Oct. 1, 2023. It now not lists lawsuits as a doable motion the system can take. A earlier model of the coverage stated accounts with balances of $300 to $5,000 could also be referred to the native county small claims court docket, and balances above $5,000 could also be topic to a lawsuit.
Atrium merged with Advocate Aurora Well being in December 2022 to change into the nation’s third-largest nonprofit well being care system, with $27 billion in annual income final 12 months. Advocate’s present collections coverage doesn’t seem to permit for lawsuits.
Two Charlotte attorneys who symbolize purchasers with medical debt stated they discovered Atrium had stopped suing sufferers when The Ledger/NC Well being Information contacted them final week.
“That’s information to me,” stated Rashad Blossom, a client legislation legal professional in Charlotte.
Judgments final for 20 years
Blossom praised the coverage change however added: “What about all of the judgments and liens they’ve now which might be good for as much as 20 years? I’ve a consumer now who has a $50,000 to $60,000 judgment in opposition to her. If she needs to promote (her home), you higher imagine they (Atrium) are going to need some cash from that.”
In North Carolina, judgments can final for 20 years and routinely place liens on folks’s properties. Additionally they accrue 8 p.c curiosity per 12 months so long as they continue to be unpaid.
Folwell, the state treasurer who has lengthy criticized the state’s nonprofit hospitals, stated in an interview he thinks Atrium ought to go additional and likewise drop its judgments in older instances.
“(Atrium Well being President) Gene Woods and his board of trustees at a snap of their finger may repair all of those issues,” Folwell stated.
It’s not with out precedent.
VCU Well being, a big medical system in Richmond, Va., introduced in 2020 that not solely was it now not going to sue sufferers, but it surely additionally promised to cancel claims associated to previous fits and take away 1000’s of liens in opposition to sufferers’ properties.
Simply because a well being care system stops submitting lawsuits doesn’t imply it should cease making an attempt to gather what it’s owed. A hospital can nonetheless attempt to acquire the debt itself, flip the debt over to a group company or promote the debt to a third-party debt collector.
Change comes too late for some sufferers
The Charlotte Ledger/NC Well being Information combed by way of court docket data to drag instances Atrium filed in opposition to sufferers in late 2022 and 2023. The data confirmed that the well being care system filed no new medical debt instances in 2023, however nonetheless pursued sufferers to gather cash on older judgments.
In February, for instance, Lionel and Brenda White of Charlotte signed an settlement with Atrium’s lawyer and began making month-to-month funds towards $50,529 in debt, court docket data present. The settlement, referred to as a Confession of Judgment, basically places any authorized motion on maintain so long as they hold paying.
The Whites informed The Ledger/NC Well being Information they felt like they needed to signal the cost settlement with Atrium as a result of they didn’t need to danger dropping their home.
They stated their medical payments mounted after Lionel had a seizure, a stroke and a coronary heart assault in 2018, and he needed to spend three days at Atrium Well being Carolinas Medical Heart.
The $50,000 they owe is greater than both of them earns in a 12 months, Brenda White stated. She works as a transit supervisor at Household Greenback, and Lionel works at an airport restaurant.
When the Whites heard that Atrium was now not pursuing sufferers in court docket, they referred to as their contact at Atrium and requested if the hospital may forgive some or the entire debt.
He informed them it wasn’t doable as a result of the brand new coverage went into impact after their case.
“That’s flawed,” Lionel White stated. “I’m nonetheless paying, and they’re forgiving all these different folks. Why aren’t they forgiving us?”
Atrium’s assertion didn’t reply to a query about whether or not they would think about dropping judgments and liens in earlier instances such because the Whites.
Nonprofit hospitals obtain tens of millions in tax breaks
Whereas hospitals are entitled to receives a commission, critics have stated they assume it goes in opposition to the establishments’ charitable missions to pursue sufferers in court docket, whilst their CEOs make tens of millions in salaries, perks and advantages. (Atrium CEO Gene Woods was paid $13.9 million in 2022.)
Nonprofit hospitals obtain tens of millions in native, state and federal tax breaks. As a public hospital, Atrium additionally enjoys different privileges, together with property tax exemptions on properties which have little or nothing to do with the availability of well being care.
Atrium officers stated beforehand that they filed lawsuits solely as a final resort, when sufferers didn’t qualify for monetary assist, didn’t apply for monetary assist or refused to speak with them.
Two takes on Atrium’s monetary help
In its most up-to-date assertion, Atrium stated it doesn’t flip away anybody needing medical care, no matter their skill to pay for care. If sufferers present the right info, Atrium will help sufferers “establish assets to assist them resolve and even get rid of their debt.”
“We’ve got a beneficiant monetary help coverage, with free and reduced-price care accessible for individuals who qualify,” the hospital stated. “ A mean of 400 sufferers every day are pre-qualified for monetary help and by no means obtain a invoice for the care we offer, totaling over $484 million annually.”
Leah Kane, an legal professional with the Charlotte Heart for Authorized Advocacy, stated a few of her purchasers had been by no means made conscious of the hospital’s monetary help program or had been denied despite the fact that they’re low-income.
“Persons are being denied simply because they’ve insurance coverage, despite the fact that they could have a $10,000 out-of-pocket cost,” she stated. “From our perspective, they doubtlessly aren’t dealing with charity care in addition to they need to.”
Proposed laws that may have helped shield sufferers was launched within the Common Meeting this 12 months, backed by Folwell. Amongst different provisions, the Medical Debt De-Weaponization Act would have capped rates of interest on medical debt at 5 p.c and required hospitals to supply free care to these whose family earnings is at or beneath 200 p.c of the federal poverty degree.
The invoice was accredited by the N.C. Senate however by no means obtained out of a Home committee.
Her debt doubled in 10 years
The court docket data searched by The Ledger/NC Well being Information present that one of many final medical debt case complaints filed by Atrium in Mecklenburg County was in opposition to Marcie Lynn Stafford in October 2022.
Stafford, 64, of Charlotte, owed $7,824 from a surgical procedure she had again in 2012, and Atrium received a case in opposition to her that 12 months. As a result of she by no means paid, the hospital system filed a brand new case 10 years later, referred to as a “renewal,” to attempt to acquire the cash. It received that case final December, court docket data present.
Reached by cellphone earlier this month, Stafford informed The Ledger/NC Well being Information she merely couldn’t afford to pay the invoice. She additionally stated she thought on the time that her well being insurer was answerable for the cost.
She didn’t attend both court docket listening to and stated she didn’t know the hospital had positioned a lien on her home till she tried to promote it earlier this 12 months.
Then, she was stunned to study that as a substitute of $7,824, she owed greater than double that – $15,780 – due to curiosity and costs.
In July, she bought her house and paid off the debt, and Atrium closed her case. Stafford stated she wished Atrium had modified its coverage about lawsuits a bit of sooner.
“I’m having a tough time,” she stated, “and I may have used that cash.”
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