By Doug Aldeen
The Great Aldeeni is on to something! – Open an Aldeen Miracle Grow Bank Account today and receive a bag of carrots and a free trip to Disney Land! – The H&R Block of IRC 501r? Take it public – The IPO has got to be a record breaker – Will the Great Aldeeni offer franchise opportunities? Count me in………..
“I would set up a booth in every grocery store across the US (much like H&R Block and its ubiquitous “tax refund” stands) and charge a flat fee to process the charity care application……….. “Honey, make sure to pick up a loaf of bread and while you are it, get our charity care application submitted. We should get back enough to take the entire family to Disney this year.” – Doug Aldeen
Washington State Attorney General Bob Ferguson announced on February 1, 2024 that Providence, one of the nation’s largest health care systems, must forgive more than $137 million in medical debt and refund more than $20 million to patients the company billed for services despite knowing they likely qualified for free or reduced-cost health care.
The $157.8 million resolution will provide full refunds, plus interest, and debt forgiveness for 99,446 individuals. It is the largest resolution of its kind in the country. Ferguson’s lawsuit asserted that between 2018 and 2023, Providence routinely disregarded its legal obligations. Instead, Providence trained staff to aggressively ask for payment from patients who were likely eligible for financial assistance, or simply billed them without determining if they qualified. In thousands of cases, Providence knowingly sent low-income patients — including Medicaid enrollees — to debt collectors. One of Providence’s own employees warned leadership that the health system’s practices were “sending the poor to bad debt.”
Thoughts Moving Forward (plus a link to a great trucker’s hat emblazoned with “Send Lawyers, Guns and Money”):
A) Every other state attorney could follow the formula that Washington State implemented and simply enforce the laws already on the books with a majority of not for profit facility’s. Any resolution should be calculated at cost and not charges. Hopefully, this is the case in this instance;
B) Congress could abolish PPO’s and implement a regional/national fee schedule for OON services;
C) Medical debt has no bearing on creditworthiness and should have no impact on an individual’s ability to obtain a loan;
D) Section 3.3.2 of the Consent Decree shifts the burden to the facility to ascertain eligibility for financial assistance before any ECA may take place;
E) Every cost containment vendor should include in its quiver the ability to perform a “retrospective charity scrub.” I would set up a booth in every grocery store across the US (much like H&R Block and its ubiquitous “tax refund” stands) and charge a flat fee to process the charity care application. “Honey, make sure to pick up a loaf of bread and while you are it, get our charity care application submitted. We should get back enough to take the entire family to Disney this year.” Remember, about 85% of the US qualifies either in whole or in part for financial assistance. $120,000 (AGI) for a family of four ( FY 2023) is 400% of the FPL;
F) See attached link for a fantastic trucker’s hat emblazoned with Warren Zevon’s most famous lyrics: ‘Send Lawyers, Guns and Money” This sage bit of advice will get you through a whole lot of problems, especially when the SHTF.
FROM TPA CONSULTANT
Yuzu Health has built a tool or product that search’s out the charity level apps by region and can bounce it off of an employers eligibility (if the can provide some salary info) and determine who is eligible at what facility.
