CHARLOTTE, NC (WBTV) — Mary Oliver says her husband Patrick is generally in good health. So, it was concerning when he started feeling numbness in his hands and feet and a burning sensation in his palms.
“It’s very unusual for him to have medical issues and then he started dragging his leg,” Mary Oliver told WBTV.
Because they were uninsured, the Atrium emergency room seemed like the only choice.
More than a year later, the Olivers are now facing a lawsuit from Atrium Health over unpaid medical bills they say they can’t afford.
A WBTV investigation found hundreds of local families in the same situation as the Olivers, being sued over unpaid medical bills that would cost them tens of thousands of dollars.
A new study raises questions about whether hospitals like Atrium and others are providing enough free charity care to patients who cannot afford the treatment they need.
Mary Oliver said they knew money would be a problem, but they fully intended to pay the bills sent to them.
Mary Oliver vividly recalls filling out personal financial forms while waiting to learn of her husband’s diagnosis.
“At that time we weren’t really concerned about what we were signing because we needed to see the doctor,” Oliver said.
Patrick told WBTV he was ready to leave the hospital after already spending hours receiving tests to determine the problem.
“I was really preparing to leave after doing a number of tests. The doctor, like I said, he was pretty nice,” Patrick Oliver said. “He said ‘No, I have to hold you’.”
Oliver was kept in the ER overnight while Atrium performed further tests and gave him an MRI. The final bill continued to rise until they owed $29,410.85.
Mary Oliver said they had been in hospital for less than 24 hours, which is supported by medical records filed in the lawsuit against them.
Oliver’s medical bills show four different MRIs totaling over $11,000.
Even after Atrium offered discounts to uninsured Oliver, the total was $15,398.72.
“We know you have to pay for what you did, but that’s ridiculous. I can’t think of anything you can do that could cost you $29,000 in less than 24 hours,” Mary Oliver said.
In an email, a spokesperson for Atrium Health said, “Free care is available for patients at 200% of the federal poverty level and below and substantial discounts for patients up to 400% of the federal poverty line”.
But even with the discounts given, the Olivers said they couldn’t afford what they currently owed.
North Carolina State Treasurer Dale Folwell is concerned about the number of North Carolinians facing medical bills like the Olivers.
“North Carolina citizens can no longer be punished by having their credit rating destroyed based on a product they would have preferred not to consume because it would mean they were in good health,” Folwell said. .
Folwell’s office, along with Johns Hopkins and the NC State Health Plan, recently released a report revealing how little tax-exempt hospital systems in Tar Heel State spend on “charitable care,” which is essentially financial assistance for bills that patients cannot afford. .
The report found that “North Carolina hospitals are reaping lucrative tax breaks to care for the poor. Their communities help bear the burden of these tax breaks, but charitable hospital care varies wildly, with little accountability. Many nonprofit hospitals do not provide enough charitable care to justify their tax exemptions.
Atrium is a government entity and, according to the report, received $440.1 million in tax exemptions in 2019-20. But “charitable care expenses were equivalent to less than 60% of his tax exemption,” or about $260.1 million.
“Isn’t that enough to justify this tax exemption they enjoy?” A WBTV reporter asked Treasurer Folwell.
“Not in the eyes of the Internal Revenue Service, but unfortunately no one actually enforces it,” Folwell said.
The report found that in North Carolina, “there is no public agency or official that enforces how nonprofit hospitals fulfill their mission to provide charitable care.”
Instead, hospital systems often seek additional tax incentives to grow.
Charlotte City Council and the Mecklenburg County Board of Commissioners recently approved reimbursing Atrium and private developers $74.5 million for public infrastructure improvements, which include parking, to begin construction of an innovation district and a medical school in Dilworth.
“What we’ve seen across North Carolina is we’ve seen the consolidation of health care in the hands of these multi-million dollar executives, who run these multi-billion dollar corporations, who are disguised as nonprofits and no one oversees,” Folwell said.
Atrium declined to answer WBTV’s on-camera questions for this story, but in an email, spokesperson Dan Fogleman wrote – “the fact is, we provide so much more than that” and claimed that Atrium “Gave back more than $2.3 billion in free and unpaid care and other benefits to the community in 2020.”
Fogelman said the hospital is eating up unreimbursed Medicare and Medicaid costs, $1.34 billion in 2020 alone.
The report specifically addresses this type of contribution and calls it lacking, saying that “many North Carolina hospitals have also made Medicare bad debts and underpayments public as community benefits. While the IRS restricts the use of these categories in calculating community benefits, some hospitals use these numbers to inflate the size of their community benefits expenditures.
That leaves people like the Olivers stuck in the middle. Atrium sued the couple for more than $17,000 in October, including attorney fees.
“A policeman came to the door to hand over the papers and when I opened it we couldn’t believe it,” Mary Oliver said.
In Mecklenburg County alone, WBTV found 111 similar lawsuits in 2021 alone, often for tens of thousands of dollars. Many of them ended in judgments against the patients.
The Olivers are still fighting.
“Hopefully something will come out of this because we don’t need judgment, we can’t afford judgment and we can’t afford all this money,” Oliver said.
Patrick Oliver was diagnosed with spinal stenosis, but ended up qualifying for a program that paid for his surgery with another health care provider, which cost him zero dollars.
Below is Atrium Health’s full response to questions posed by WBTV.
“You quoted a report with a low number for charitable care and, the fact is, we provide so much more than that. Not only does Atrium Health provide the most health care to residents across the state, but we are also proud to be the largest provider of community benefits. Our company gave back more than $2.3 billion in free and unpaid care and other community benefits in 2020. (Just Mecklenburg Co.in 2020 – $910 million )
Our financial statements are audited annually and one of the major shortcomings of the report you refer to is that it excludes non-payments and underpayments from the overall benefit count.
Atrium Health is the largest Medicaid provider in the state – and we serve 70% of the Medicaid population in Mecklenburg County. What many people don’t understand is that the Medicare and Medicaid programs don’t reimburse hospitals for the full amount it costs to provide care in many cases. We cannot refuse these patients or negotiate higher reimbursements. Government payers recognize this fact and expect hospitals to make up the difference through savings and other sources of revenue. The financing of this unpaid public debt is considered a community benefit.
Free care is available for patients at 200% of the federal poverty level and below and substantial discounts for patients up to 400% of the federal poverty level. We also incurred $1.34 billion in unreimbursed costs for treating Medicare and Medicaid patients in 2020.
We also care for people in need in other ways. Throughout the COVID pandemic, Atrium Health has eliminated disparities by ensuring racial equity in access to testing and vaccines. We took the two straight to underserved neighborhoods. And, as the state faces an ongoing behavioral health crisis, Atrium Health has maintained a deep commitment to our behavioral health programs, investing more than $79 million annually in treating some of the most vulnerable of our population.
Due to the privacy of our patients, we cannot speak to any specific case. It is important to note that with our “for all” mission, we do not turn anyone away – regardless of their ability or inability to pay – but we are required to treat all patients who are not eligible for financial aid. when it comes to collection practices, regardless of the amount owed. When people are racking up bills and need help, we’re happy to work with them to set up a payment plan for what they can afford. When the appropriate information is provided to us, we can usually determine plans or programs that might help them resolve – or eliminate – their debt.
Atrium Health strives to provide financial assistance based on the patient’s ability to pay while modeling Atrium Health’s core value of caring. Our financial assistance programs are designed to ensure that assistance is provided to patients demonstrating financial need and to ensure that Atrium Health complies with any required federal or state regulations relating to financial assistance. For more information, patients may contact Patient Customer Service at 704-512-7171 or visit www.AtriumHealth.org.
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