Hospital tries to stick ER nurse with $1 million in debt for her preemie’s care

Patrick Malone & Associates P.C. | DC Injury Lawyers
Contact

Patrick Malone & Associates P.C. | DC Injury Lawyers

bardbaby-240x300It’s the price and cost problem, stupid. That’s a fictitious but new tattoo that voters might want politicians to take up as they consider the many major problems with the American health care system, especially as yet more medical billing outrages surface.

Marshall Allen, a reporter for ProPublica, the Pulitzer Prize-winning investigative site, posted about a doozy: It’s about almost $1 million in charges that a hospital group sought to saddle a new mom with, even as she wrestled with pregnancy complications and an ailing premature baby.

That mom also happened to be an emergency room nurse. And the chain that flubbed her medical bill was her own employer: Dignity hospitals. That’s a Christian medical enterprise that describes itself as the fifth largest health system in the nation and has as its motto, “Hello, human kindness.” As Allen reported, it’s worth noting this, too, about Dignity:

“In 2018, the organization reported $6.6 billion in net assets and paid its CEO $11.9 million in reportable compensation, according to tax filings. That same year more than two dozen Dignity executives earned more than $1 million in compensation, records show.”

But Dignity hung its ER nurse Lauren Bard out to dry after her difficult pregnancy, treated by specialists at the University of California, Irvine, hospital. Bard delivered her daughter Sadie at 26 weeks and weighing less than a pound and a half. The preemie was rushed into a neonatal intensive care unit, as mother Bard herself struggled with an infection and had to be hospitalized.

The young nurse also had enough presence of mind to call the administrator of her health plan, Anthem Blue Cross, to discuss her care and coverage. Anthem and UCI both assured her not to worry.

But later, Bard found that Dignity self-insures, meaning it covers the bulk of its employees’ health care costs. Her employer — no matter what Anthem and UCI had said — told Bard that she had missed a 31-day window after delivering Sadie to fill out forms to ensure the baby got covered by Bard’s policy. In repeated appeals, Dignity told its nurse that she was out of luck and would be responsible for her big medical bills, which soon mounted to almost $1 million. Representatives told her that she should have read her insurance information, given to her six years earlier when she signed up.  As Allen found, Dignity also mistakenly told Bard that the company could not cut her a one-off break without possible consequences from the Internal Revenue Service.

Now, here’s where medical voodoo occurred: Bard, distraught over the possibility of paying medical bills for the rest of her life or her impending financial ruin, took to Facebook. She posted a picture of her largest bill, an invoice for more than $898,000. That photo was routed to ProPublica, which has, like several news organizations, sought to report on medical bill outrages.

Allen took up Bard’s dispute with Dignity. And, shazam, the health system suddenly found its compassion. It granted Bard an exemption and agreed to handle her whopping medical bills. But not before the nurse, already suffering post-partum depression, said she was traumatized beyond imagination.

Horror stories aplenty about medical debt

Her experiences, alas, are far from unique. In recent days, the independent, nonpartisan Kaiser Health News Service posted news articles on medical debtors, including one a grief-stricken mom, who, during a painful holiday, drank too many beers and sent too many concerning messages,. That got her sent for emergency hospitalization for mental health issues. After less than a week of extensive testing, sobering up, and some pointed chats with family and doctors, she has stopped drinking and is working on her issues. These now include how she will pay more than $20,000 in medical bills she racked up and which won’t be covered by a “skimpy,” association health insurance she took out.

Another KHN article described the financial plight of a graphic designer in suburban Los Angeles. He suffered from idiopathic pulmonary fibrosis, which the news story described as, “a progressive disease that scars lung tissue and makes it increasingly difficult to breathe.” He had gotten on the list for a lung transplant when he stopped breathing. He was transported to a nearby hospital by ground ambulance and was hospitalized briefly before he got super lucky — lungs became available to him for transplant.

To undergo the urgent procedure, doctors decided to fly him to a major academic medical center 27 miles away. As KHN reported, though, the patient later learned:

“[He] discovered the helicopter company, which was out of his [health insurance] network, had charged the insurance company $51,282 for the flight, and [he] was responsible for the portion his insurance didn’t cover: $11,524.79. By contrast, the charges from the day of his transplant surgery totaled $40,575 — including $31,605 for his surgeon — and were fully covered by Anthem [his insurer].”

Again, there’s a positive outcome to this story, after the air ambulance firm hounded the patient for payment. His insurer ended up contracting with the company, so others in its coverage won’t get hit in similar fashion. But, more important, publicity about this case, including a network broadcast, led the air ambulance firm to wipe away the bill.

Others aren’t so fortunate, KHN reported:

“The median cost of a helicopter air ambulance flight was $36,400 in 2017, an increase of more than 60% from the median price in 2012, according to a Government Accountability Office analysis. Two-thirds of the flights in 2017 were out-of-network, the report found. The air ambulance industry justifies these charges by pointing out that the bulk of its business — transporting patients covered by the public insurance programs Medicare and Medicaid — is severely underfunded by the government. The median cost to transport a Medicare patient by air ambulance is about $10,200, according to an industry study. However, air ambulance companies are reimbursed a median rate of $6,500 per flight. ‘The remaining 30% of patients with private health insurance end up paying over 70% of the costs,’ said [a spokesman for a national air ambulance service.”

The news service also revisited an earlier, excellent investigation into the harsh billing practices of the University of Virginia medical system. Although UVA has pledged to do better by its patients, and that it will wipe out or negotiate with more compassion the significant bills that exist, the enterprise hasn’t detailed its plans. Meantime, the dunning persists and those with recent and closed cases aren’t sure how or if UVA might do right for them, potentially saving them, for example, from losing property.

For those seeking a national perspective on crazy medical bills, medical debt, and hospitals dogging patients, especially the poor, over unpaid debt, the New York Times has weighed in with a detailed read on the issue.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care. This has become an ordeal due to the skyrocketing cost, complexity, and uncertainty of medical treatments and prescription medications, too many of which turn out to be dangerous drugs.

Politicians and out-of-control health care costs

Although ProPublica, KHN, the New York Times, and the news site Vox deserve a salute from the bill-paying public for their watchdog work on medical providers, it is unacceptable that institutions respond only and mostly to public blaming-and-shaming. Why aren’t they listening to and helping their crucial customers — patients who also struggle with illness and injury as they try to cope with bankrupting medical bills.

Voters are fed up with the abusive aspects of health care, especially when it comes to outrageous expenses that not only are unjustified and inexplicable but can be waved away as if by magic when questioned in public fashion. Politicians, Democrats notably, seem to have heard the outcry. But they have allowed themselves to get caught up in policy tussles over the distant but desirable good of universal health coverage while downplaying what could be achieved by dealing with health care costs.

The New York Times reported that Pete Buttigieg, the Democratic hopeful and South Bend, Ind., mayor, has suggested a willingness to tackle health care costs with controls. Although other Democrats have talked about attacking Big Pharma’s sky-high prices, Buttigieg also is taking on hospitals — which have big money, lots of employees, and formidable political clout. Elizabeth Warren, the Massachusetts senator, also appears to be talking tougher about prices and costs in health care.

It would be good to see robust discussion of these ideas, rather than political reporters obsessing about magical words like “middle class tax hikes” to pay for a single-payer, Medicare for All plan. That option is worth discussion, even if, honestly, it may be more aspiration than reality.

The reality also persists that the Grand Old Party is determined to keep the federal government out of any role in health care, even if that inflicts punishing harm on the sick, injured, poor, working poor, middle class, children, and the elderly. Republicans — though they may fib that they aren’t doing what they are doing — have pushed a federal court case that could kill the Affordable Care Act. That could mean an end to patient protections against insurers’ caps on lifetime benefits and their discriminating against those with preexisting conditions (far too many of us). The Trump Administration, despite much boasting about its never-delivered ACA alternative and a fully realized health care plan, is scrambling behind the scenes to figure what it might do if the courts eliminate the ACA.

A November 2019 electoral message

Virginia voters made clear this will not do, turning the state from purple to deeply Democratic blue. With the legislature and state house firmly in Democratic hands, perhaps there will be common sense regulation of firearms and no efforts to slash at Medicaid.

In Kentucky, the gubernatorial race ended up in a razor-thin Democratic victory. Let’s see if that stands, because it would, among other things, halt the unpopular GOP-led efforts to slash at Medicaid in the Bluegrass state.

The voters’ message is ringing out, politicians: Do good things to help with runaway costs and improve the health care Americans get. We’ve got work to do before that critical 2020 vote.

Photo credit: Lauren Bard and baby Sadie, 13 months, by Arlene Mejorado for ProPublica

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Patrick Malone & Associates P.C. | DC Injury Lawyers | Attorney Advertising

Written by:

Patrick Malone & Associates P.C. | DC Injury Lawyers
Contact
more
less

Patrick Malone & Associates P.C. | DC Injury Lawyers on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
- hide

JD Supra Privacy Policy

Updated: May 25, 2018:

JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.

This Privacy Policy describes how JD Supra, LLC ("JD Supra" or "we," "us," or "our") collects, uses and shares personal data collected from visitors to our website (located at www.jdsupra.com) (our "Website") who view only publicly-available content as well as subscribers to our services (such as our email digests or author tools)(our "Services"). By using our Website and registering for one of our Services, you are agreeing to the terms of this Privacy Policy.

Please note that if you subscribe to one of our Services, you can make choices about how we collect, use and share your information through our Privacy Center under the "My Account" dashboard (available if you are logged into your JD Supra account).

Collection of Information

Registration Information. When you register with JD Supra for our Website and Services, either as an author or as a subscriber, you will be asked to provide identifying information to create your JD Supra account ("Registration Data"), such as your:

  • Email
  • First Name
  • Last Name
  • Company Name
  • Company Industry
  • Title
  • Country

Other Information: We also collect other information you may voluntarily provide. This may include content you provide for publication. We may also receive your communications with others through our Website and Services (such as contacting an author through our Website) or communications directly with us (such as through email, feedback or other forms or social media). If you are a subscribed user, we will also collect your user preferences, such as the types of articles you would like to read.

Information from third parties (such as, from your employer or LinkedIn): We may also receive information about you from third party sources. For example, your employer may provide your information to us, such as in connection with an article submitted by your employer for publication. If you choose to use LinkedIn to subscribe to our Website and Services, we also collect information related to your LinkedIn account and profile.

Your interactions with our Website and Services: As is true of most websites, we gather certain information automatically. This information includes IP addresses, browser type, Internet service provider (ISP), referring/exit pages, operating system, date/time stamp and clickstream data. We use this information to analyze trends, to administer the Website and our Services, to improve the content and performance of our Website and Services, and to track users' movements around the site. We may also link this automatically-collected data to personal information, for example, to inform authors about who has read their articles. Some of this data is collected through information sent by your web browser. We also use cookies and other tracking technologies to collect this information. To learn more about cookies and other tracking technologies that JD Supra may use on our Website and Services please see our "Cookies Guide" page.

How do we use this information?

We use the information and data we collect principally in order to provide our Website and Services. More specifically, we may use your personal information to:

  • Operate our Website and Services and publish content;
  • Distribute content to you in accordance with your preferences as well as to provide other notifications to you (for example, updates about our policies and terms);
  • Measure readership and usage of the Website and Services;
  • Communicate with you regarding your questions and requests;
  • Authenticate users and to provide for the safety and security of our Website and Services;
  • Conduct research and similar activities to improve our Website and Services; and
  • Comply with our legal and regulatory responsibilities and to enforce our rights.

How is your information shared?

  • Content and other public information (such as an author profile) is shared on our Website and Services, including via email digests and social media feeds, and is accessible to the general public.
  • If you choose to use our Website and Services to communicate directly with a company or individual, such communication may be shared accordingly.
  • Readership information is provided to publishing law firms and authors of content to give them insight into their readership and to help them to improve their content.
  • Our Website may offer you the opportunity to share information through our Website, such as through Facebook's "Like" or Twitter's "Tweet" button. We offer this functionality to help generate interest in our Website and content and to permit you to recommend content to your contacts. You should be aware that sharing through such functionality may result in information being collected by the applicable social media network and possibly being made publicly available (for example, through a search engine). Any such information collection would be subject to such third party social media network's privacy policy.
  • Your information may also be shared to parties who support our business, such as professional advisors as well as web-hosting providers, analytics providers and other information technology providers.
  • Any court, governmental authority, law enforcement agency or other third party where we believe disclosure is necessary to comply with a legal or regulatory obligation, or otherwise to protect our rights, the rights of any third party or individuals' personal safety, or to detect, prevent, or otherwise address fraud, security or safety issues.
  • To our affiliated entities and in connection with the sale, assignment or other transfer of our company or our business.

How We Protect Your Information

JD Supra takes reasonable and appropriate precautions to insure that user information is protected from loss, misuse and unauthorized access, disclosure, alteration and destruction. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. You should keep in mind that no Internet transmission is ever 100% secure or error-free. Where you use log-in credentials (usernames, passwords) on our Website, please remember that it is your responsibility to safeguard them. If you believe that your log-in credentials have been compromised, please contact us at privacy@jdsupra.com.

Children's Information

Our Website and Services are not directed at children under the age of 16 and we do not knowingly collect personal information from children under the age of 16 through our Website and/or Services. If you have reason to believe that a child under the age of 16 has provided personal information to us, please contact us, and we will endeavor to delete that information from our databases.

Links to Other Websites

Our Website and Services may contain links to other websites. The operators of such other websites may collect information about you, including through cookies or other technologies. If you are using our Website or Services and click a link to another site, you will leave our Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We are not responsible for the data collection and use practices of such other sites. This Policy applies solely to the information collected in connection with your use of our Website and Services and does not apply to any practices conducted offline or in connection with any other websites.

Information for EU and Swiss Residents

JD Supra's principal place of business is in the United States. By subscribing to our website, you expressly consent to your information being processed in the United States.

  • Our Legal Basis for Processing: Generally, we rely on our legitimate interests in order to process your personal information. For example, we rely on this legal ground if we use your personal information to manage your Registration Data and administer our relationship with you; to deliver our Website and Services; understand and improve our Website and Services; report reader analytics to our authors; to personalize your experience on our Website and Services; and where necessary to protect or defend our or another's rights or property, or to detect, prevent, or otherwise address fraud, security, safety or privacy issues. Please see Article 6(1)(f) of the E.U. General Data Protection Regulation ("GDPR") In addition, there may be other situations where other grounds for processing may exist, such as where processing is a result of legal requirements (GDPR Article 6(1)(c)) or for reasons of public interest (GDPR Article 6(1)(e)). Please see the "Your Rights" section of this Privacy Policy immediately below for more information about how you may request that we limit or refrain from processing your personal information.
  • Your Rights
    • Right of Access/Portability: You can ask to review details about the information we hold about you and how that information has been used and disclosed. Note that we may request to verify your identification before fulfilling your request. You can also request that your personal information is provided to you in a commonly used electronic format so that you can share it with other organizations.
    • Right to Correct Information: You may ask that we make corrections to any information we hold, if you believe such correction to be necessary.
    • Right to Restrict Our Processing or Erasure of Information: You also have the right in certain circumstances to ask us to restrict processing of your personal information or to erase your personal information. Where you have consented to our use of your personal information, you can withdraw your consent at any time.

You can make a request to exercise any of these rights by emailing us at privacy@jdsupra.com or by writing to us at:

Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

You can also manage your profile and subscriptions through our Privacy Center under the "My Account" dashboard.

We will make all practical efforts to respect your wishes. There may be times, however, where we are not able to fulfill your request, for example, if applicable law prohibits our compliance. Please note that JD Supra does not use "automatic decision making" or "profiling" as those terms are defined in the GDPR.

  • Timeframe for retaining your personal information: We will retain your personal information in a form that identifies you only for as long as it serves the purpose(s) for which it was initially collected as stated in this Privacy Policy, or subsequently authorized. We may continue processing your personal information for longer periods, but only for the time and to the extent such processing reasonably serves the purposes of archiving in the public interest, journalism, literature and art, scientific or historical research and statistical analysis, and subject to the protection of this Privacy Policy. For example, if you are an author, your personal information may continue to be published in connection with your article indefinitely. When we have no ongoing legitimate business need to process your personal information, we will either delete or anonymize it, or, if this is not possible (for example, because your personal information has been stored in backup archives), then we will securely store your personal information and isolate it from any further processing until deletion is possible.
  • Onward Transfer to Third Parties: As noted in the "How We Share Your Data" Section above, JD Supra may share your information with third parties. When JD Supra discloses your personal information to third parties, we have ensured that such third parties have either certified under the EU-U.S. or Swiss Privacy Shield Framework and will process all personal data received from EU member states/Switzerland in reliance on the applicable Privacy Shield Framework or that they have been subjected to strict contractual provisions in their contract with us to guarantee an adequate level of data protection for your data.

California Privacy Rights

Pursuant to Section 1798.83 of the California Civil Code, our customers who are California residents have the right to request certain information regarding our disclosure of personal information to third parties for their direct marketing purposes.

You can make a request for this information by emailing us at privacy@jdsupra.com or by writing to us at:

Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

Some browsers have incorporated a Do Not Track (DNT) feature. These features, when turned on, send a signal that you prefer that the website you are visiting not collect and use data regarding your online searching and browsing activities. As there is not yet a common understanding on how to interpret the DNT signal, we currently do not respond to DNT signals on our site.

Access/Correct/Update/Delete Personal Information

For non-EU/Swiss residents, if you would like to know what personal information we have about you, you can send an e-mail to privacy@jdsupra.com. We will be in contact with you (by mail or otherwise) to verify your identity and provide you the information you request. We will respond within 30 days to your request for access to your personal information. In some cases, we may not be able to remove your personal information, in which case we will let you know if we are unable to do so and why. If you would like to correct or update your personal information, you can manage your profile and subscriptions through our Privacy Center under the "My Account" dashboard. If you would like to delete your account or remove your information from our Website and Services, send an e-mail to privacy@jdsupra.com.

Changes in Our Privacy Policy

We reserve the right to change this Privacy Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our Privacy Policy will become effective upon posting of the revised policy on the Website. By continuing to use our Website and Services following such changes, you will be deemed to have agreed to such changes.

Contacting JD Supra

If you have any questions about this Privacy Policy, the practices of this site, your dealings with our Website or Services, or if you would like to change any of the information you have provided to us, please contact us at: privacy@jdsupra.com.

JD Supra Cookie Guide

As with many websites, JD Supra's website (located at www.jdsupra.com) (our "Website") and our services (such as our email article digests)(our "Services") use a standard technology called a "cookie" and other similar technologies (such as, pixels and web beacons), which are small data files that are transferred to your computer when you use our Website and Services. These technologies automatically identify your browser whenever you interact with our Website and Services.

How We Use Cookies and Other Tracking Technologies

We use cookies and other tracking technologies to:

  1. Improve the user experience on our Website and Services;
  2. Store the authorization token that users receive when they login to the private areas of our Website. This token is specific to a user's login session and requires a valid username and password to obtain. It is required to access the user's profile information, subscriptions, and analytics;
  3. Track anonymous site usage; and
  4. Permit connectivity with social media networks to permit content sharing.

There are different types of cookies and other technologies used our Website, notably:

  • "Session cookies" - These cookies only last as long as your online session, and disappear from your computer or device when you close your browser (like Internet Explorer, Google Chrome or Safari).
  • "Persistent cookies" - These cookies stay on your computer or device after your browser has been closed and last for a time specified in the cookie. We use persistent cookies when we need to know who you are for more than one browsing session. For example, we use them to remember your preferences for the next time you visit.
  • "Web Beacons/Pixels" - Some of our web pages and emails may also contain small electronic images known as web beacons, clear GIFs or single-pixel GIFs. These images are placed on a web page or email and typically work in conjunction with cookies to collect data. We use these images to identify our users and user behavior, such as counting the number of users who have visited a web page or acted upon one of our email digests.

JD Supra Cookies. We place our own cookies on your computer to track certain information about you while you are using our Website and Services. For example, we place a session cookie on your computer each time you visit our Website. We use these cookies to allow you to log-in to your subscriber account. In addition, through these cookies we are able to collect information about how you use the Website, including what browser you may be using, your IP address, and the URL address you came from upon visiting our Website and the URL you next visit (even if those URLs are not on our Website). We also utilize email web beacons to monitor whether our emails are being delivered and read. We also use these tools to help deliver reader analytics to our authors to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

Analytics/Performance Cookies. JD Supra also uses the following analytic tools to help us analyze the performance of our Website and Services as well as how visitors use our Website and Services:

  • HubSpot - For more information about HubSpot cookies, please visit legal.hubspot.com/privacy-policy.
  • New Relic - For more information on New Relic cookies, please visit www.newrelic.com/privacy.
  • Google Analytics - For more information on Google Analytics cookies, visit www.google.com/policies. To opt-out of being tracked by Google Analytics across all websites visit http://tools.google.com/dlpage/gaoptout. This will allow you to download and install a Google Analytics cookie-free web browser.

Facebook, Twitter and other Social Network Cookies. Our content pages allow you to share content appearing on our Website and Services to your social media accounts through the "Like," "Tweet," or similar buttons displayed on such pages. To accomplish this Service, we embed code that such third party social networks provide and that we do not control. These buttons know that you are logged in to your social network account and therefore such social networks could also know that you are viewing the JD Supra Website.

Controlling and Deleting Cookies

If you would like to change how a browser uses cookies, including blocking or deleting cookies from the JD Supra Website and Services you can do so by changing the settings in your web browser. To control cookies, most browsers allow you to either accept or reject all cookies, only accept certain types of cookies, or prompt you every time a site wishes to save a cookie. It's also easy to delete cookies that are already saved on your device by a browser.

The processes for controlling and deleting cookies vary depending on which browser you use. To find out how to do so with a particular browser, you can use your browser's "Help" function or alternatively, you can visit http://www.aboutcookies.org which explains, step-by-step, how to control and delete cookies in most browsers.

Updates to This Policy

We may update this cookie policy and our Privacy Policy from time-to-time, particularly as technology changes. You can always check this page for the latest version. We may also notify you of changes to our privacy policy by email.

Contacting JD Supra

If you have any questions about how we use cookies and other tracking technologies, please contact us at: privacy@jdsupra.com.

- hide

This website uses cookies to improve user experience, track anonymous site usage, store authorization tokens and permit sharing on social media networks. By continuing to browse this website you accept the use of cookies. Click here to read more about how we use cookies.