In response to a Kaiser Health News investigation into University of Virginia Health System’s aggressive collection practices, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) sent a letter Thursday demanding answers to questions about UVA’s billing practices, financial assistance policies and even its prices.Special Reports Investigation
Over six years, the state institution filed 36,000 lawsuits against patients seeking a total of more than $106 million in unpaid bills, a KHN analysis finds.
The Finance Committee oversees federal tax laws, and Grassley wrote that it is “my job to make sure that entities exempt from tax are fulfilling their tax-exempt purposes.”
The KHN investigation found that UVA Health System, a taxpayer-supported and state-funded entity, filed 36,000 lawsuits for more than $106 million in six years.
“Unfortunately, I have seen a variety of news reports lately discussing what appear to be relentless debt-collection efforts by tax-exempt hospitals, including UVA Health System,” Grassley wrote. “I am also concerned about how patients’ hospital bills get so high in the first place.”
Even though the letter only questions UVA Health System, whose practices were pegged in the investigation as particularly aggressive, it sends a signal that the Senate will be paying attention to an issue that impacts all state run and nonprofit health systems. Many medical providers pursue patients for unpaid bills, sometimes forcing them into bankruptcy. Several news stories have highlighted similar collections practices at other nonprofit hospitals.
Nonprofit hospitals get big tax breaks in exchange for providing “charity care and community benefit,” though there is no clear standard about what that should mean. Experts have questioned whether those breaks are deserved, given hospitals’ pricing, billing and collections practices.
In the seven-page letter, Grassley asks 19 detailed questions on various topics, including the system’s charity care (free or discounted care provided to low-income patients), debt collection policies, and its rationale for the litigation threshold of $1,000, enacted in 2017. Grassley asks specific questions about UVA’s standard price list, commonly known as the “chargemaster,” which lists prices for procedures and equipment posted on its website.Email Sign-Up
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The letter was addressed to CEO Pamela Sutton-Wallace, who will depart UVA Health System for NewYork–Presbyterian Hospital next month. UVA Health System has until Nov. 19 to respond.
“UVA is committed to assisting indigent and uninsured patients and making sure they receive all necessary care,” UVA Health System spokesman Eric Swensen said in an email to KHN. “We will review the letter, and look forward to working with Sen. Grassley to respond to his questions and share with him the policy changes we have announced and started implementing over the past month to better serve our patients.”
In response to KHN’s investigation, UVA Health System swiftly vowed to change its policies to increase financial assistance, give bigger discounts to the uninsured and reduce its use of the legal system. However, KHN reported that some critics do not think the news policies go far enough.
Do low-wage workers respond to high-pressure labor markets by increasing their labor supply? What evidence is there that tight job markets pull in such workers? We find highly cyclical responses to both the extensive and intensive margins of labor supply for low-income, prime-age persons.
"To have this animal walk by and, you know, offer you its unconditional love. That tail wag has the ability to make that day, and I see that all the time in the hospital."
Can’t see the audio player? Click here to listen on SoundCloud.Julie Rovner
Kaiser Health NewsRead Julie's Stories Joanne Kenen
PoliticoRead Joanne's Stories Tami Luhby
CNNRead Tami's Stories Margot Sanger-Katz
The New York TimesRead Margot's Stories
Despite the turmoil from the ongoing impeachment inquiry, Democrats in the U.S. House of Representatives are proceeding with work on a major prescription drug price bill crafted by House Speaker Nancy Pelosi.
Meanwhile, broader health issues continue to be a point of contention among the Democratic presidential candidates.
And courts around the country are dealing setbacks to many of the Trump administration’s health agenda items, including one that would make it harder for immigrants to get green cards if they use public programs.
This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Tami Luhby of CNN, and Margot Sanger-Katz of The New York Times.
Among the takeaways from this week’s podcast:
- Getting an ambitious drug pricing package through Congress by the end of the year seems unlikely, not only because of impeachment, but because the Senate is not on board with Speaker Pelosi’s plan.
- Still, a Congressional Budget Office analysis released this week found the Pelosi bill would save Medicare $345 billion over 10 years, giving Democrats a major talking point. On the other hand, the CBO also suggested the measure could reduce the number of new drugs that come to market by 8 to 15 in the coming decade, providing a talking point for opponents.
- Also of interest, the House Energy and Commerce Committee is planning to consider adding some benefits — including dental, vision and hearing — to traditional Medicare. It’s not clear if this is a response to the campaign season, or the idea that before pursuing “Medicare for All” there are changes to the traditional Medicare program that could be done.
- Health care again was a hot topic in this week’s Democratic presidential primary debate and Massachusetts Sen. Elizabeth Warren, now viewed as the front-runner, was in the hot seat. Warren again evaded the question of how and who would pay for her preferred Medicare for All plan, and was criticized by candidates like Sen. Amy Klobuchar of Minnesota and Mayor Pete Buttigieg of South Bend, Ind., both of whom support more incremental changes to the health system.
- Meanwhile, the courts continue to play a key role in health policy. Federal judges in several states blocked the administration’s “public charge” rule that would make it harder for legal immigrants to obtain green cards if they or their family members use any of a long list of public programs. Federal judges also heard arguments on Medicaid work requirements. Meanwhile, a federal judge in Ohio blocked an Ohio state abortion ban, while a federal court judge in Texas blocked an Obama era rule intended to enforce anti-discrimination provisions of the Affordable Care Act.
Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:
Julie Rovner: KHN’s “We Vape, We Vote’: How Vaping Crackdowns Are Politicizing Vapers, by Rachel Bluth and Lauren Weber
Joanne Kenen: The Los Angeles Times’s “In the rush to harvest body parts, death investigations have been upended,” by Melody Petersen
Tami Luhby: ProPublica’s “It’s Very Unethical”: Audio Shows Hospital Kept Vegetative Patient on Life Support to Boost Survival Rates,” by Caroline Chen
Margot Sanger-Katz: “Tradeoffs,” a podcast hosted by Dan Gorenstein, Sayeh Nikpay, and Anupam Jena
To hear all our podcasts, click here.
Viewpoints: Warren Needs To Find New Way To Answer Question About ‘Medicare For All’ Costs; Finally, Mental Health Needs Of Children Get Important Boost During Opioid Epidemic
State Highlights: Man’s Suicide In Jail Underscores Mental Health Crisis In Mississippi; Top Surgeon Returns To Troubled Johns Hopkins Children’s Hospital In St. Pete
Teen Suicide Rate Increases 56% CDC Report Shows, Prompting Pleas For Awareness Among Parents, Teachers
With Millions Of Baby Boomers Expected To Get Alzheimer’s, Experts Puzzle Over Best Ways To Avoid Bleak Future
Public Safety Panel Investigating Parkland Shooting Says Florida’s Mental Health System Too Often A Revolving Door
Despite Federal Guidance, Most State Medicaid Programs Still Reluctant To Pay For Pricey Hep C Treatment
Kaiser Permanente Ratifies New Contract With Union Representing About 57,000 Of Its Health Care Workers
The following is a guest post by Anna Price, a legal reference librarian at the Law Library of Congress.
This edition of Research Guides In Focus covers another frequently-accessed Law Library guide – U.S. Supreme Court Records and Briefs. I regularly direct patrons to this guide, and rely on it for quick answers to Supreme Court research questions.
The Law Library of Congress is one of only ten depository libraries that holds a print collection of Records and Briefs of the United States Supreme Court. While the availability of these volumes on subscription databases has improved accessibility to Supreme Court materials, a few organizations have gone a step further and made these records freely available online over the last few years. That said, finding electronic copies of Supreme Court Records and Briefs from a particular time period can be challenging.
The guide addresses this issue by listing where to find Supreme Court Records and Briefs in print and microform, as well through free electronic resources and subscription databases, accompanied by the dates of coverage for each resource. In addition to the Supreme Court’s electronic filing system, which became operational in November 2017, the guide directs visitors to resources like FindLaw, the Office of the Inspector General, and SCOTUSBlog to retrieve Supreme Court Records and Briefs.
The guide also provides information on accessing oral argument transcripts and recordings, dockets, and other resources, such as The Journal of the Supreme Court of the United States.
We hope you will find this guide helpful in your research. As always, if you have any questions, please contact us through Ask A Librarian.
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If you've watched Democratic presidential debates, you've heard of Medicare for All. But there’s little information about what the system might mean for your costs. So we created a basic formula, and four individuals and families in Massachusetts agreed to help test it.
For our analysis, we used three tax rates -- 11.5%, 15% and 18% -- to calculate what health care might cost our four Massachusetts individuals and families if the Unites States transitions to a single-payer system.