Arkansas’ public university hospital has sued thousands of patients over medical bills during the pandemic, including hundreds of its own nurses and employees

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CNN
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As Covid cases spread in 2020, visitors to the University of Arkansas for Medical Sciences were greeted by a colorful sign put up by grateful neighbors outside the university’s medical center: “Heroes Work Here.”

The university adopted the message in glossy promotional videos it posted online, introducing viewers to individual nurses, doctors, and health workers who described their jobs. “Sometimes it’s easy for people who pass through here to see our frontline caregivers as the heroes, or our educators as the heroes – it’s really everybody,” Cam Patterson, the university chancellor, declared in one video. 

But at least a dozen of the “heroes” that UAMS featured in online advertisements and other videos weren’t just employed by the university – they’ve also been sued by it. 

UAMS, Arkansas’ flagship public health sciences university, has been aggressively suing thousands of former patients over medical debt in recent years, including hundreds of its own employees, a CNN investigation found. 

Since 2019, UAMS has sued more than 8,000 patients to collect on unpaid medical bills, according to court records. It filed more debt collection lawsuits in recent years than any other plaintiff in the Arkansas court system other than the state tax office.

The university’s use of the courts ballooned during the coronavirus pandemic. It filed 35 lawsuits in 2016 but more than 3,000 in 2021 – an average of nearly nine a day.

CNN reviewed court documents from thousands of UAMS lawsuits and identified more than 500 defendants who were listed as working for the university itself. The employees ranged from nurses and patient services associates to clinical technicians and lab workers to housekeepers and cooks.

Twenty people sued by UAMS, including more than a dozen current or former employees, spoke to CNN about their cases. Keri Whimper, a former UAMS medical assistant, said the university’s lawsuit against her – demanding a total of about $700 for a bill she thought had been covered by insurance – felt like a betrayal after she contracted Covid while working at the medical center.

“I worked for them through Covid, and they’re still doing this to me,” she said. “This really shows they don’t care about their employees at all.”

UAMS, which is part of the state government and is Arkansas’ largest public employer, operates a major teaching hospital in the state capital of Little Rock and runs clinics around the state. Its legal practices, which have not been previously reported, are an example of how aggressive medical debt collection efforts aren’t limited to corporate, for-profit hospitals.

Most of the lawsuits UAMS filed in recent years involved unpaid medical bills of about $1,000 or less, with some cases over as little as $100. In its complaints, the university tacked on hundreds of dollars of court filing fees, attorney fees, service fees, and interest charges, sometimes doubling or tripling the original amount owed. It moved to garnish defendants’ wages

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$102,000 was the bill for her teen’s stay in a state mental hospital : Shots

Bridget Narsh at her home in Chapel Hill, North Carolina. Narsh’s son has autism, post-traumatic stress disorder, and ADHD. In 2020, he spent more than 100 days at Central Regional Hospital, a state-run mental health facility. The state billed the family nearly $102,000 for the hospitalizations.

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Bridget Narsh at her home in Chapel Hill, North Carolina. Narsh’s son has autism, post-traumatic stress disorder, and ADHD. In 2020, he spent more than 100 days at Central Regional Hospital, a state-run mental health facility. The state billed the family nearly $102,000 for the hospitalizations.

Eamon Queeney/KFF Health News

Bridget Narsh’s son, Mason, needed urgent help in January 2020, so she was offered the chance to send him to Central Regional Hospital, a state-run mental health facility in Butner, North Carolina.

The teen, who deals with autism and post-traumatic stress and attention-deficit/hyperactivity disorders, had started destroying furniture and running away from home. His mother worried for the safety of Mason and the rest of the family.

But children in crisis in North Carolina can wait weeks or months for a psychiatric bed because the state lacks the services to meet demand. And when spots do become available, they are expensive.

The standard rate at Central Regional was $1,338 a day, which Narsh could not afford. So, when a patient relations representative offered a discounted rate of less than $60 a day, her husband, Nathan, signed an agreement.

Mason, now 17, was hospitalized for more than 100 days in Central Regional over two separate stays that year, documents show.

But when requests for payment arrived the following year, Narsh said she was shocked. The letters — which were marked “final notice” and requested immediate payment — were signed by a paralegal in the office of Josh Stein, North Carolina’s attorney general. The total bill, $101,546.49, was significantly more than the roughly $6,700 the Narshes expected to pay under their agreement with the hospital.

“I had to tell myself to keep my cool,” says Bridget Narsh, 44, who lives with her husband and three children in Chapel Hill. “There is no way I could pay for this.”

Medical bills have upended the lives of millions of Americans, with hospitals putting liens on homes and pushing many people into bankruptcy. In recent years, lawmakers have railed against privately operated hospitals, and states have passed laws intended to make medical billing more transparent and limit aggressive debt collection tactics.

Some state attorneys general — as their states’ top law enforcement officials — have pursued efforts to shield residents from harmful billing and debt collection practices. But in the name of protecting taxpayer resources, their offices are also often responsible for collecting unpaid debts for state-run facilities, which can put them in a contradictive position.

Stein, a Democrat running for governor in 2024, has made hospital consolidation and health care price transparency a key issue during his time in office.

“I have real concerns about this

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A Development Look at on Hospital Price tag Transparency

For many years, U.S. hospitals have usually stonewalled patients who needed to know forward of time how significantly their care would value. Now that is altering — but there is a vigorous debate above what hospitals are disclosing.

Under a federal rule in outcome since 2021, hospitals nationwide have been laboring to post a mountain of info on the internet that spells out their prices for each individual assistance, drug, and product they give, including the real costs they’ve negotiated with insurers and the quantities that money-shelling out people would be charged. They’ve carried out so begrudgingly and only following losing a lawsuit that challenged the federal rule.

How perfectly they’re undertaking relies upon on whom you talk to.

The rule aims to pull again the curtain on opaque healthcare facility costs that might differ greatly by hospital for the very same assistance or even in the exact same hospital. The expectation is that rate transparency will increase competition, offering individuals and companies a way to review rates and make knowledgeable choices, ultimately driving down the price of treatment. Whether or not that will materialize is not however crystal clear.

Insurers and big businesses are also required to write-up their negotiated prices with all their companies, below separate principles that took outcome last summer months.

Hospitals have created “substantial progress,” in accordance to an analysis by the federal Centers for Medicare & Medicaid Services of 600 randomly chosen hospitals that was revealed in the journal Wellness Affairs previous thirty day period. The company appeared at no matter if hospitals had achieved their obligation to submit rate facts on the web in two essential formats: a “shoppable” record of at minimum 300 services for buyers, and a thorough machine-readable file that incorporates all the solutions for which the clinic has conventional expenses. This file really should be in a structure that makes it possible for researchers, regulators, and others to examine the facts.

CMS discovered that 70% of hospitals printed both equally lists in 2022. An further 12% released a person or the other. By contrast, the agency’s earlier progress evaluation in 2021 found that just 27% of 235 hospitals experienced the two styles of lists.

The 2022 assessment “represents a marked advancement,” stated Dr. Meena Seshamani, deputy administrator and director of the Middle for Medicare at CMS, in a assertion. But she also explained the innovations are continue to “not sufficient” and CMS will carry on to use “technical support and enforcement activity” so that all hospitals “fully comply with the legislation.”

The American Medical center Affiliation claimed the CMS evaluation demonstrated the development hospitals experienced created less than extremely hard situation as they grappled with the covid-19 pandemic.

“These are sophisticated insurance policies that went into result in the most challenging time in hospitals’ heritage,” explained Molly Smith, group vice president for policy at the trade affiliation. “And we have found raises in compliance above the earlier 18 months.”

Some groups that have appeared at the

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Medical debt soars for consumers with hospital credit cards : Shots

Many hospitals are now partnering with financing companies to offer payment plans when patients and their families can’t afford their bills. The catch: the plans can come with interest that significantly increases a patient’s debt.

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Many hospitals are now partnering with financing companies to offer payment plans when patients and their families can’t afford their bills. The catch: the plans can come with interest that significantly increases a patient’s debt.

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Patients at North Carolina-based Atrium Health get what looks like an enticing pitch when they go to the nonprofit hospital system’s website: a payment plan from lender AccessOne. The plans offer “easy ways to make monthly payments” on medical bills, the website says. You don’t need good credit to get a loan. Everyone is approved. Nothing is reported to credit agencies.

In Minnesota, Allina Health encourages its patients to sign up for an account with MedCredit Financial Services to “consolidate your health expenses.” In Southern California, Chino Valley Medical Center, part of the Prime Healthcare chain, touts “promotional financing options with the CareCredit credit card to help you get the care you need, when you need it.”

As Americans are overwhelmed with medical bills, patient financing is now a multibillion-dollar business, with private equity and big banks lined up to cash in when patients and their families can’t pay for care. By one estimate from research firm IBISWorld, profit margins top 29% in the patient financing industry, seven times what is considered a solid hospital margin.

Hospitals and other providers, which historically put their patients in interest-free payment plans, have welcomed the financing, signing contracts with lenders and enrolling patients in financing plans with rosy promises about convenient bills and easy payments.

For patients, the payment plans often mean something more ominous: yet more debt.

Millions of people are paying interest on these plans, on top of what they owe for medical or dental care, an investigation by KHN and NPR shows. Even with lower rates than a traditional credit card, the interest can add hundreds, even thousands of dollars to medical bills and ratchet up financial strains when patients are most vulnerable.

Robin Milcowitz, a Florida woman who found herself enrolled in an AccessOne loan at a Tampa hospital in 2018 after having a hysterectomy for ovarian cancer, said she was appalled by the financing arrangements.

“Hospitals have found yet another way to monetize our illnesses and our need for medical help,” said Milcowitz, a graphic designer. She was charged 11.5% interest — almost three times what she paid for a separate bank loan. “It’s immoral,” she said.

Robin Milcowitz signed on to a no-interest payment plan to pay off $3,000 she owed for a hysterectomy in 2017. When the medical center switched her account to AccessOne, she began receiving late notices, though she was making payments. Turned out her payments were only being applied to the surgery, leaving an account for medical appointments past-due.

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Penn Highlands Breaks Floor for $70 Million Point out School Spot Hospital and Healthcare Place of work Developing

A style and design rendering exhibits the exterior of Penn Highlands Healthcare’s new $70 million clinic and health care place of work building that is under development in Patton Township. Impression presented

Development is underway for Penn Highlands Healthcare’s new Condition Higher education place medical center and health care business creating.

Penn Highlands officers have been joined by local local community leaders on Tuesday for a ceremonial groundbreaking at the clinic web-site in the Patton City Middle development on Colonnade Boulevard, at the rear of Sheetz and Cracker Barrel.

When finished in spring 2024, the $70 million facility in Patton Township will be the overall health system’s ninth medical center, but very first it has developed and built from the ground up considering the fact that it was shaped in 2011.

“This is a momentous day for Penn Highlands Healthcare and the Centre County local community,” Mark Norman, main running officer, claimed. “While Penn Highlands has eight hospitals in northwest, central and southwestern Pennsylvania, today’s groundbreaking marks the to start with time we are designing and building a really client-centric healthcare facility to satisfy today’s well being care needs in the location.”

Penn Highlands Healthcare officers on Tuesday, May well 24, held a ceremonial groundbreaking for a new clinic and healthcare business setting up to be positioned at Patton City Centre alongside Colonnade Boulevard. Picture by Geoff Rushton | StateCollege.com

The three-story, 82,000-square-foot clinic and two-story, 32,000-square-foot clinical business developing will largely be geared towards outpatient care, however will supply some inpatient products and services.

Norman claimed that is reflective of traits in health and fitness treatment above the earlier two decades.

“People are getting sophisticated care past the walls of hospitals and are getting a lot more reliant on outpatient care,” he said. “Twenty yrs in the past when someone needed a diagnosis, in some cases that required inpatient admission and tons of tests that experienced to be carried out on an inpatient foundation. Today… the improvements in outpatient technologies and fewer invasive treatment which generally can be accomplished on an outpatient foundation [are] why we’re psyched about this facility.

“That does not suggest we really do not need to have hospitals. We nonetheless do, but inpatient care is becoming far more reserved for those people that really have to have it.”

The hospital will include an unexpected emergency section with 10 non-public remedy rooms and a trauma room a surgical section with three superior-tech operating suites and an endoscopy method home 18 personal inpatient rooms a medical imaging section and a pulmonary functionality lab for screening prognosis and remedy.

“Our patients will be greeted with condition of the artwork improvement from the minute they enter this constructing,” Rhonda Halstead, regional current market president, stated. “Penn Highlands Condition College will be a person of the most technically state-of-the-art hospitals in the area.”

Connected to the healthcare facility will be the medical office environment creating, which will present a stroll-in clinic delivering treatment to men and women of all

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Hit with $7,146 for two hospital bills, a family sought health care in Mexico : Shots

Claudia and Jesús Fierro of Yuma, Ariz., review their medical bills. They pay $1,000 a month for health insurance yet still owed more than $7,000 after two episodes of care at the local hospital.

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Claudia and Jesús Fierro of Yuma, Ariz., review their medical bills. They pay $1,000 a month for health insurance yet still owed more than $7,000 after two episodes of care at the local hospital.

Lisa Hornak for Kaiser Health News

The Fierro family of Yuma, Ariz., had a string of bad medical luck that started in December 2020.

That’s when Jesús Fierro Sr. was admitted to the hospital with a serious case of COVID-19. He spent 18 days at Yuma Regional Medical Center, where he lost 60 pounds. He came home weak and dependent on an oxygen tank.

Then, in June 2021, his wife, Claudia Fierro, fainted while waiting for a table at the local Olive Garden restaurant. She felt dizzy one minute and was in an ambulance on her way to the same medical center the next. She was told her magnesium levels were low and was sent home within 24 hours.

The family has health insurance through Jesús Sr.’s job, but it didn’t protect the Fierros from owing thousands of dollars. So when their son Jesús Fierro Jr. dislocated his shoulder, the Fierros — who hadn’t yet paid the bills for their own care — opted out of U.S. health care and headed south to the U.S.-Mexico border.

And no other bills came for at least one member of the family.

The patients: Jesús Fierro Sr., 48; Claudia Fierro, 51; and Jesús Fierro Jr., 17. The family has Blue Cross and Blue Shield of Texas health insurance through Jesús Sr.’s employment with NOV, formerly National Oilwell Varco, an American multinational oil company based in Houston.

Medical services: For Jesús Sr., 18 days of inpatient care for a severe case of COVID-19. For Claudia, fewer than 24 hours of emergency care after fainting. For Jesús Jr., a walk-in appointment for a dislocated shoulder.

Total bills: Jesús Sr. was charged $3,894.86. The total bill was $107,905.80 for COVID-19 treatment. Claudia was charged $3,252.74, including $202.36 for treatment from an out-of-network physician. The total bill was $13,429.50 for less than one day of treatment. Jesús Jr. was charged $5 (70 pesos) for an outpatient visit that the family paid in cash.

Service providers: Yuma Regional Medical Center, a 406-bed nonprofit hospital in Yuma, Ariz. It’s in the Fierros’ insurance network. And a private doctor’s office in Mexicali, Mexico, which is not.

What gives: The Fierros were trapped in a situation in which more and more Americans find themselves. They are what some experts term “functionally uninsured.” They have insurance — in this case, through Jesús Sr.’s job, which pays $72,000 a year. But their health plan is expensive, and they don’t have the liquid savings to pay their share of

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