Approximately 43,000 former patients of Santa Clara Valley Healthcare, serving Santa Clara County in California, will soon receive notice of possible billing corrections and refunds.
The increased patient outreach efforts are part of the settlement of a lawsuit that alleged the county did not adequately inform three former patients about its previous hospital charity care and discount payment policies after they incurred bills ranging from $8,000 to $35,000 between 2013 and 2017. The bills were sent to collections, according to Santa Clara County.
At the time of their hospitalization, one petitioner was uninsured who was a single mother of two children and a full-time student; another was uninsured and spoke primarily Spanish; and the third was unemployed and unhoused.
WHAT’S THE IMPACT
As part of the settlement, the county will provide an opportunity for patients whose bills were sent to collections between October 28, 2018, and December 31, 2021, to have their bills re-reviewed for full or partial discounts.
People who receive this notice will have 65 days to complete and return a form indicating their interest to apply. They’ll then have an additional 150 days to complete their application by submitting documents to verify their information.
Tens of thousands of people treated at Santa Clara County-owned hospitals may now qualify to have their medical debt erased.
This comes in the wake of a June lawsuit settlement that accused Santa Clara Valley Healthcare of charging needy patients for care they should have received for free.
The county said yesterday it has begun notifying patients who should have been eligible for “charity care,” reduced-cost or free medical services for low-income people. Those who apply in the next several weeks could see their outstanding hospital bills voided, have court judgements corrected and even receive refund checks in the mail.
The settlement is a major win for patient advocates like Helen Tran, a senior attorney with the Western Center on Law and Poverty who worked on the case.
“It sends a really important message to hospitals statewide—that they should take their charity care obligations seriously,” she told San José Spotlight. “The county has done so.”
All acute care hospitals in California must offer charity care to anyone uninsured, and many people with insurance, who earn below a certain threshold—currently 400% of the federal poverty level. That’s about $58,000 annually for an individual and $120,000 for a family of four. Patients must also be told about charity care options in their native language.
If you are a former patient at Santa Clara Valley Medical Center, you may be owed some cash. The hospital has started notifying more than 40,000 former patients about refunds due to incorrect billing. It is part of a settlement involving patients who were sent to collections for charges that they never should have been asked to pay. Joining us live now to discuss the settlement is Helen Tran, senior attorney with Western Center on Law and Poverty, which filed the suit back in 2019.
Santa Clara Valley Healthcare is notifying 43,000 former patients that they may be eligible for refunds or billing corrections because the medical facility did not fulfill its charity care obligations.
This action stems from a settlement of a lawsuit filed in 2019, alleging that the public hospital system failed to apprise three former patients of its charity care program or discounted payment policies. The plaintiffs said that they received bills ranging from $8,000 to $35,000 between 2013 and 2017. Those bills were subsequently sent to collections.
The revelation of the settlement was initially reported by KFF Health News.
Among the plaintiffs was a single mother of two, who was a full-time student and uninsured. Another was an unhoused resident.
In accordance with California’s Hospital Fair Pricing Policies law, people unable to afford their medical expenses can qualify for partial or complete bill forgiveness through charity care. Eligibility for charity care extends to patients regardless of their insurance or immigration status.
California’s largest public hospital plans to start notifying 43,000 former patients Monday that they may be eligible for refunds or billing corrections, part of what advocates called a major legal settlement that will help force the hospital to fulfill its charity care obligations.
Santa Clara Valley Medical Center, along with other units of county-owned Santa Clara Valley Healthcare, will also adopt procedures to ensure patients are informed of their eligibility for charity care, which nonprofit and public hospitals must provide.
“This is huge,” said Helen Tran, a senior attorney with Western Center on Law & Poverty, which joined another California-based legal group, the Consumer Law Center, in a lawsuit against the hospital. “It’s so important that the hospital is stepping up to take corrective action. That’s something we haven’t seen many hospitals do.”
Filed in 2019 and settled in June, the lawsuit alleged that Santa Clara Valley Medical Center billed patients and sent them to collections for charges they should not have been required to pay. Emily Hepner, one of the plaintiffs, was a full-time student, raising two children alone,and uninsured in 2014 when she needed urgent surgery, according to the lawsuit. The hospital never followed up after telling her she might be eligible for charity care and, nearly a year later, she received a $34,884 bill. The hospital later sued her for that amount plus attorney fees.
Approximately 43,000 Former Santa Clara Valley Healthcare Patients to Receive Notice of Potential Eligibility for Charity Care or a Discount on Their Medical Bills
Santa Clara County, CA – Approximately 43,000 former patients of Santa Clara Valley Healthcare will soon receive notice of possible billing corrections and refunds. These corrective actions from the County of Santa Clara complement the significant enhancements that the County’s Board of Supervisors has made in recent years to the County’s hospital charity care and discount payment program, the Healthcare Access Program (HAP).
The increased patient outreach efforts are part of the settlement of a lawsuit that alleged the County did not adequately inform three former patients about its previous hospital charity care and discount payment policies after they incurred bills ranging from $8,000 to $35,000 between 2013 and 2017 and the bills were sent to collections. At the time of their hospitalization, one petitioner was uninsured, a single mother of two children, and a full-time student; another was uninsured and spoke primarily Spanish; and the third was unemployed and unhoused.
“Our goal in this lawsuit was to have better policies and processes in place at the hospital to inform patients of their right to charity care and to give patients who did not know about these programs in the past the chance to apply for discounts to their bills now,” said Fred Schwinn, Attorney with the Consumer Law Center, Inc.
The County’s patient notices include detailed information about how patients can qualify for free and discounted payments. The notices and posters advertising the program at the hospital are available in seven non-English languages. Written information about charity care and discount payments is given to patients at the time of service or mailed to patients within a few days after discharge. The County will also continue to assist patients with financial assistance applications and applications for government-sponsored health coverage such as Medi-Cal. Additionally, patients may apply for financial assistance at any time during the course of the collections process.
“Santa Clara Valley Healthcare prides itself on delivering quality healthcare for individuals and communities that face significant socioeconomic hurdles to receiving this basic benefit,” said Paul E. Lorenz, Chief Executive Officer for Santa Clara Valley Healthcare. “These newly implemented outreach efforts, combined with our current programs, multilingual approaches, and recent state-initiated efforts, will allow us to better serve those most in need.”
As part of settling this lawsuit, the County will provide an opportunity for patients whose bills were sent to collections between October 28, 2018, and December 31, 2021, to have their bills re-reviewed for full or partial discounts. Individuals who receive this notice will have 65 days to complete and return a form indicating their interest to apply. Individuals will then have an additional 150 days to complete their application by submitting documents to verify their information. Depending on when patients’ bills were sent to collections, they may qualify for different financial assistance programs. Patients may be eligible for refunds for amounts they overpaid and to have court judgments corrected.
“Medical debt, particularly hospital debt, burdens many Californians and forces them to forgo medically necessary care and other life necessities. We hope this lawsuit will give thousands of Santa Clara residents some financial relief,” said Helen Tran, Senior Attorney with the Western Center on Law and Poverty. “We are impressed the County has committed to the enormous task of reconsidering past bills that may have qualified for free care or some level of discount.”
In California, all licensed acute care hospitals must provide financial assistance to uninsured patients and patients who have high medical costs. The County of Santa Clara Board of Supervisors has long been committed to going above and beyond these requirements. In April 2020, the Board of Supervisors approved the creation of the Healthcare Access Program (HAP), which provides a full discount to eligible hospital patients whose yearly household income is at or below 400% of the Federal Poverty Level (FPL), as well as options for significantly discounted payments for patients whose income is between 401% and 650% of the FPL, making it one of the most generous and innovative hospital charity care and discount payment programs in the United States. For more information about the HAP, please visit this webpage.
Patients who receive a notice about this settlement may contact Santa Clara Valley Healthcare at (408) 494-7850 for assistance. Patients may also contact the Health Consumer Alliance at (888) 804-3536 to receive free assistance about how to qualify for a refund.
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Western Center on Law & Poverty fights in courts, cities, counties, and in the Capitol to secure housing, health care, and a strong safety net for Californians with low incomes, through the lens of economic and racial justice. For more information, visit www.wclp.org.
Located in downtown San Jose, California, Consumer Law Center, Inc., devotes its entire practice to protecting the rights of California consumers. CLC’s practice is exclusively limited to representing individuals in debt collection lawsuits and consumer class action cases against debt buyers and debt collectors. For more information, visit https://www.sjconsumerlaw.com/ and https://debt-defenders.com/.
About Santa Clara Valley Healthcare
Santa Clara Valley Healthcare (SCVH), California’s second-largest County-owned health and hospital system, is comprised of three acute care hospitals, Santa Clara Valley Medical Center, O’Connor Hospital, and St. Louise Regional Hospital, along with a network of primary and specialty clinics. SCVH emphasizes quality care, research, teaching, innovation, and most importantly, a focus on coordinated, compassionate, and patient-centered care to every patient. Our mission is to provide high-quality, accessible healthcare and excellent service to everyone in Santa Clara County, regardless of their socioeconomic status or ability to pay.
We began this Black History Month honoring Derrick Bell, one of Western Center’s founding members, past executive director, and a leading voice in the school of that thought that would become critical race theory. We honor our rich history, standing on the shoulders of giants as we continue the critical work of eliminating anti-Blackness in Housing, Health, Public Benefits, and Access to Justice. The urgency of this work was reinforced by this month’s release of research documenting persistent racism with the systems we work to transform: the largest study on birth outcomes in the state of California revealed that Black birthing folks, regardless of income level, continue to face the most adverse maternal and infant mortality rates; more than half of Black Californians (55%) said there was a time in the last few years when they thought they would have gotten better care if they had belonged to a different racial or ethnic group; and the housing and homelessness crisis continues to disproportionately impact Black Californians. This year, we are expanding our team to tackle the racism Black and Brown birthing folks experience, alleviate the burden of medical debt, and take on housing voucher discrimination and environmental racism. We look forward to sharing more about this expanded work.
Join us on March 14th at 12PM PST as our Policy Team rolls out our 2023 legislative agenda to secure housing, healthcare, and a strong safety net for Californians with low incomes. We’ll be diving into the work of the Consent and Reproductive Equity (CARE) for Families Act, establishing the first statewide Fair Chance Housing Ordinance, eliminating housing voucher discrimination, the restoration of stolen CalFresh benefits, CalWORKs expansions, eliminating poverty tows and much, much more! You don’t want to miss this powerful conversation by the folks on the frontlines of California’s anti-poverty policy movement. You can read about the bills we are co-sponsoring and track the status of our bills’ activities on our legislative tracker page.
Senior Attorney, Helen Tran and Director of Litigation, Richard Rothschild discuss why Western Center joined Disability Rights California and Public Interest Law Project to sue the State in this latest blog post: Contrary to some strong opinions that CARE Court is “California’s only real plan for helping our most vulnerable and seriously mentally ill,” Governor Newsom never planned to truly provide behavioral health treatment and housing through this bill. The CARE Act does not mandate counties to provide behavioral health treatment or housing; it creates no new rights or benefits for people with schizophrenia and other psychotic disorders who are summoned to court to join the CARE process. Rather, all CARE Court-ordered services are “subject to available funding… In other words, services will only be provided as they are available.
Hospitals run by Los Angeles County could make free care available to more of their financially strapped patients under a new proposal aimed at expanding relief from medical bills — the result of a class-action lawsuit brought by Western Center on behalf of people who had sought medical care from the county. Under the proposed rules, free care would be available to eligible L.A. County residents with incomes under 200% of the federal poverty level. David Kane, Senior Attorney, spoke to the impact of these rules in last week’s Los Angeles Times’ article. People earning under 200% of the federal poverty level “certainly cannot afford high medical costs — or even what other people consider to be modest medical costs.” Making care available to them at no cost “is definitely the right thing to do, because those are the people who need this the most.”
Despite Western Center’s work to pass SB329 to prevent discrimination in the use of housing vouchers, voucher holders continue to face a series of obstacles in securing affordable housing as documented in the New York Times’ recent feature tracking one young woman’s journey to use her Section 8 voucher in Los Angeles County. Landing an apartment in Los Angeles County can be an arduous journey in a region struggling with a housing shortage and homelessness crisis, where even those with steady middle-class salaries have found themselves in a rat race for a home. For the impoverished, the search can feel ultimately impossible.“ Are you going to interrupt your search to fight every landlord who says, ‘I’m not going to rent to you because you have Section 8?’” said Nisha Vyas, Senior Attorney with the Western Center on Law and Poverty. “It’s more likely you’re going to keep trying to find someone who’s going to say yes.”
Over 15 million Californians will need to renew their Medi-Cal starting in June. To learn the latest on how Medi-Cal renewals will work, join Western Center and National Health Law Program (NHeLP) TOMORROW, March 1st at 2PM PT/5 PM ET for a webinar tailored for advocates, application assisters, and community-based organizations. The federal COVID-19 Public Health Emergency (PHE) implemented flexibilities that help people get on, and stay on, Medi-Cal. This continuous Medi-Cal coverage requirement will end on March 31, 2023. Beginning April 1, 2023 counties across the state will begin annual Medi-Cal renewals for all beneficiaries.
Public education, outreach and advocacy will be critical to ensuring that individuals and families do not lose their Medi-Cal coverage in error. This webinar will provide an overview of the federal and state guidance on Medi-Cal renewals, what to expect, and advocacy efforts protect Californians’ access to health coverage.
Many Californians, whether insured, underinsured, or uninsured, are carrying the burdens of medical debt in their lives. This year, Western Center co-sponsored AB 1020 (Friedman) to address this problem. AB 1020 strengthens the existing Hospital Fair Pricing Act, which requires California hospitals to provide free or discounted care to uninsured and underinsured patients who are low income; and the Rosenthal Fair Debt Collection Practices Act and Fair Debt Buying Practices Act, which require debt collectors and debt buyers to follow fair debt collection procedures.
The amendments aim to inform more people of the availability of financial assistance when receiving hospital services and hold hospitals, debt collectors, and debt buyers accountable to this assistance. Since the Hospital Fair Pricing Act was passed 15 years ago, legal services advocates have navigated an opaque application process with their clients who should have qualified for charity care but never received notice or an application. Patients were left in murky negotiating situations when they had to deal with accounts that had been assigned or sold to debt collectors and debt buyers. Patients needed a clearer application process. AB 1020 does the following:
Our Health Care Practice Tip this month details these changes and more. One common unlawful provision found in many hospitals’ fair pricing policies is a specific time period to apply, often set at 150 days. These deadlines violate the Hospital Fair Pricing Act, which allows patients to apply for charity care or discounted payments at any time, without time limit. Meanwhile, hospitals may still commence collection activity after the statutory time period has passed. The Health Care Practice Tip explains this issue.
Even in the pandemic, the accumulation and collection of medical debt have not stopped. Our state’s charity care and collections laws still require rigorous enforcement by advocates.
“Sometimes when people see any kind of bill, they think they need to pay it,” says Jen Flory, a policy advocate at the Western Center on Law & Poverty, which supported the legislation. “So unless they understand that, ‘Oh, I reached my deductible, or my out-of-pocket max,’ people panic and do whatever they need to do to pay the bill. And it can be hard to get the money back from providers if they pay unnecessarily.”
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