28 hospitals named in report flagging predatory medical billing in Texas

Despite rising unemployment claims due to COVID-19, hospitals are still suing patients in Texas for unpaid medical bills, according to a report from researchers from the Johns Hopkins University in Baltimore and several other academic institutions.

The report analyzes predatory medical billing practices in Texas and examines lawsuits and garnishments for patient medical debt from 2018 to 2020. What researchers found is 7 percent — or 28 — of the 414 hospitals studied sued patients for unpaid medical bills. Five of the hospitals garnished the bank accounts and personal property of patients. Twenty-two of the hospitals were Texas-based, while six were suing from out of state.

In Texas, hospitals are required to bill a patient's health plan, if they have one, first. This includes out-of-network providers. Hospitals can't require an employer to take money from a paycheck, and vehicles, homes and other property are exempt from creditors. 

In a statement to Becker's Hospital Review, the Texas Hospital Association, which represents more than 85 percent of the state's acute care hospitals, said hospitals are "in the business of taking care of people" and use "more significant action to recoup certain costs as a last resort." The association added that these costs are sometimes deductibles for services that an insurer won't pay for, and hospitals may have charity care policies in place to resolve the issues. 

In the report, researchers found the average revenue of 15 of the hospitals that sued patients was $972 million, with the hospitals suing for an average of 0.15 percent of their total revenue, or $17.8 million. Comparatively, in 9 out of 10 counties where hospitals sued patients, median household incomes were well below the national average.
"In interviewing Texas hospital board leaders and CEOs, some were not aware they were suing patients. Even if they were aware, they assumed they were suing those with the means to pay their bill or that they needed to sue to 'keep the hospital lights on,'" the report said. "However, after extensive review, over half the patients being sued represented low to low-middle income class families. Furthermore, the lawsuit amounts were negligible in comparison to the hospitals' overall revenues." 

View the full report here

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