About 43K California patients are receiving refunds and billing corrections

Photo: Martin Barraud/Getty Images

Approximately 43,000 former patients of Santa Clara Valley Healthcare, serving Santa Clara County in California, will soon receive notice of possible billing corrections and refunds.

The increased patient outreach efforts are part of the settlement of a lawsuit that alleged the county did not adequately inform three former patients about its previous hospital charity care and discount payment policies after they incurred bills ranging from $8,000 to $35,000 between 2013 and 2017. The bills were sent to collections, according to Santa Clara County.

At the time of their hospitalization, one petitioner was uninsured who was a single mother of two children and a full-time student; another was uninsured and spoke primarily Spanish; and the third was unemployed and unhoused.

WHAT'S THE IMPACT?

As part of the settlement, the county will provide an opportunity for patients whose bills were sent to collections between October 28, 2018, and December 31, 2021, to have their bills re-reviewed for full or partial discounts.

People who receive this notice will have 65 days to complete and return a form indicating their interest to apply. They'll then have an additional 150 days to complete their application by submitting documents to verify their information.

Depending on when patients' bills were sent to collections, they may qualify for different financial assistance programs. Patients may be eligible for refunds for the amounts they overpaid, and to have court judgments corrected.

In California, all licensed acute care hospitals must provide financial assistance to uninsured patients and patients who have high medical costs. The County of Santa Clara Board of Supervisors said it has taken this a step further: In April 2020, the board approved the creation of the Healthcare Access Program (HAP), which provides a full discount to eligible hospital patients whose yearly household income is at or below 400% of the Federal Poverty Level (FPL), as well as options for discounted payments for patients whose income is between 401% and 650% of the FPL.

The board described it as "one of the most generous and innovative hospital charity care and discount payment programs in the United States."

THE LARGER TREND

The county's patient notices include detailed information about how patients can qualify for free and discounted payments. The notices and posters advertising the program at the hospital are available in seven non-English languages. Written information about charity care and discount payments is given to patients at the time of service or mailed to patients within a few days after discharge. 

The county said it will also continue to assist patients with financial assistance applications and applications for government-sponsored health coverage such as Medi-Cal. Additionally, patients may apply for financial assistance at any time during the course of the collections process.

ON THE RECORD

"Our goal in this lawsuit was to have better policies and processes in place at the hospital to inform patients of their right to charity care and to give patients who did not know about these programs in the past the chance to apply for discounts to their bills now," said Fred Schwinn, attorney with the Consumer Law Center.

"Medical debt, particularly hospital debt, burdens many Californians and forces them to forgo medically necessary care and other life necessities," said Helen Tran, senior attorney with the Western Center on Law and Poverty. "We hope this lawsuit will give thousands of Santa Clara residents some financial relief."
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com