Group examines faith-based hospitals’ billing

Gillian Flaccus

Wednesday, Aug. 24, 2005 | 11:13 a.m.

LOS ANGELES -- A nonprofit group that represents the uninsured is launching a multistate effort to determine if faith-based hospitals are price-gouging patients without health coverage.

K.B. Forbes, executive director of the Los Angeles-based Consejo de Latinos Unidos, alleged the hospitals routinely charge uninsured patients up to five times the amount paid by private insurers and government programs for the same services.

Forbes said his organization will spend up to $20,000 next week to run announcements on English- and Spanish-language radio stations asking people to report possible incidents of overbilling and deception at facilities owned by Catholic Healthcare West and other companies.

The group, which offers free legal aid to the uninsured, will analyze the responses and prepare a report for Congress and the California Attorney General's Office. The investigation will later expand to target facilities in Arizona, Colorado and Ohio.

San Francisco-based Catholic Healthcare West operates 40 hospitals in California, Arizona and Nevada. Catholic Healthcare West operates two hospitals in Southern Nevada: The St. Rose Dominican Hospitals -- Siena Campus and the St. Rose Dominican Hospitals -- Rose de Lima Campus. The company is also building a third hospital in the southwest Las Vegas Valley, off the Las Vegas Beltway, a facility scheduled to open in August 2006.

"We are not talking about the poorest of the poor. They qualify for Medi-Cal or Medicaid," Forbes said at a news conference announcing the effort. "We're talking about middle class, hardworking Americans who are stuck paying the bill."

Mark Klein, vice president of communications for Catholic Healthcare West, didn't immediately return calls for comment. Calls to his assistant also went unanswered.

Jan Emerson, spokeswoman for the California Hospital Association, said the allegations were unfounded. She said California hospitals lost $6.5 billion by providing health care to uninsured and underinsured patients in 2004. The association represents 500 hospitals statewide.

She pointed out that private insurers and government insurance programs negotiate lower rates for large groups of people that are unavailable to the uninsured.

"The underlying issue in this whole debate is the problem of the insurance. We have to find a way to get every single person a basic level of health insurance," Emerson said. "Our basic job is to provide care. We do it every day, regardless of somebody's ability to pay or not. We are not the financers of care."

Emerson said Catholic Healthcare West was among the hospital groups that agreed to offer discounts to uninsured families who don't qualify for government programs. The cutoff for such discounts at Catholic Healthcare West is an income equal to about $78,000 a year for a family of four, she said.

At the news conference, Pedro Romo, 42, said he was subjected to price gouging and unfair billing practices at California Medical Center, a Catholic Healthcare West hospital.

Romo, of Los Angeles, said he took his wife to the emergency room in 2001 for treatment of an infected cyst. He said he paid $200 in cash and believed that was the full fee. He later received a bill for $1,324 from California Medical, he said.

Romo has disputed the bill with the help of Forbes' organization. He said he can't pay and was recently denied credit at a department store because of the debt.

"From the beginning, I told Catholic Healthcare West I didn't have insurance. They said, 'Just give us $200 and we will attend to you,' " Romo said through a translator.

In 2003, Santa Barbara-based Tenet Healthcare Inc. agreed to discounted rates for the uninsured after an aggressive campaign by Forbes' group. Nashville-based HCA Inc. said the same year that it would offer discounts to low-income uninsured patients following a similar campaign.

Emerson and other hospital officials have suggested that Forbes is acting on behalf of his friend and former employer, insurance company owner and conservative millionaire Patrick Rooney.

Rooney has long been interested in driving down medical costs to encourage the use of tax-free health savings accounts, which he sells through his company, Medical Savings Co.

Forbes acknowledged that Rooney is a good friend who has helped him gain the support of congressional allies. But Forbes said his organization does not get any money from labor unions, political parties or insurance companies.

He declined to say whether Rooney has personally contributed to Consejo de Latinos Unidos, as some reports have suggested.

"I make no bones about it. Pat Rooney is a friend ... but our work is to help the uninsured, period," Forbes said.