Renton, Wash.-based Providence Health & Services and Seattle-based Swedish Health Services will pay $1.4 million to resolve a complaint alleging the health systems used an out-of-network laboratory for pathology testing, which increased costs for patients, according to a Seattle Times report.
Here are seven things to know.
1. The Washington Attorney General's Office filed the complaint in King County Superior Court, alleging the health systems violated the state's consumer protection laws.
2. Both health systems allegedly used laboratory CellNetix — which is not in network for many patients — for pathology testing for more than a year, according to the report. They are accused of not notifying patients of the company's out-of-network status.
3. More specifically, the AG's office alleges Mountlake Terrace, Wash.-based insurer Premera Blue Cross notified Providence and Swedish about CellNetix's out-of-network status in 2015, according to the report. However, the systems allegedly failed to let patients know for more than a year.
4. The AG, in the complaint cited by the Seattle Times, said Providence and Swedish officials received internal warnings as well as notification of the issue from Premera. Additionally, other warnings reportedly occurred, including one from a hospital employee.
5. Still, the healthcare providers continued to contract with CellNetix, and patients were charged out of network, according to the report.
6. While Providence and Swedish have agreed to pay $1.4 million, the systems did not admit liability as part of the consent decree resolving the complaint. The settlement includes $385,101 in restitution for as many as 6,400 affected patients.
7. Providence and Swedish provided the following statement to the Seattle Times. "We know that this experience frustrated our patients who received these unexpected bills and we have taken steps to prevent this issue from arising again."
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