From a lawsuit filed by Washington state's attorney general to being questioned by a U.S. senator, Renton, Wash.-based Providence's alleged debt collection practices have come under question from government officials this year.
Providence has denied wrongdoing.
"As the largest provider of charity care in the state of Washington, the Providence family of organizations provided $75.5 million in free and discounted care statewide in 2021 alone," a spokesperson told Becker's earlier this year. "We also absorbed $471 million in uncompensated Medicaid costs last year in Washington state. Our practices comply with, and in many instances exceed, the requirements of Washington's Charity Care Act."
Feb. 24: Washington state's attorney general filed a lawsuit against Providence, alleging that 14 of its hospitals engaged in aggressive tactics to collect payments, failed to ensure discounts for eligible low-income patients, and steered poor patients to debt collectors.
Attorney General Bob Ferguson's consumer protection lawsuit claims that Providence began an effort, called Rev-Up, with assistance from McKinsey in 2018 to substantially increase the amount of payments collected directly from patients. Staff who interact with patients were directed to attempt collecting payment on hospital bills in every interaction with a motto of "Ask Every Patient Every Time." Providence allegedly trained staff to collect payment with tactics that did not make the availability of charity care known, including specific phrasing to patients such as, "How would you like to pay today?"
Providence called the charges "inaccurate and unfair."
Aug. 9: The attorney general's office added two collection agencies to the lawsuit. Mr. Ferguson alleges Harris & Harris and Optimum Outcomes failed to notify tens of thousands of patients of the availability of charity care discounts before "aggressively collecting on their medical debt." He also alleges they failed to inform patients of their right to request certain information about their debt.
Sept. 28: U.S. Senator Patty Murray of Washington sent a letter seeking answers from Providence's CEO following a Sept. 24 New York Times report detailing the system's alleged debt collection practices.
Ms. Murray said in her letter she was seeking answers to several questions, including how much it paid McKinsey & Co. for Rev-Up.
Oct. 2: Citing an "unintended error," Providence said it will reimburse about 760 Medicaid patients whose accounts were sent to debt collectors.
Oct. 3: Providence shared an internal message it sent following the New York Times' report. CFO Greg Hoffman called the crux of the Times' allegations — that Providence intentionally changed its policy to send those who were eligible for charity care to debt collections — "categorically untrue."
Oct. 12: Providence CEO Rod Hochman responded to Ms. Murray's questions. He said the Rev-Up program was short-lived and no longer exists. The letter said the intent was "not to target those in financial distress. Rather, it focused on helping those who are commercially insured and have the means to pay, better understand their out-of-pocket costs."
"We acknowledge that the original training materials, and even the name Rev-Up, were not consistent with our values," Mr. Hochman wrote. "The training was modified over time to ensure the availability of financial assistance and our values of compassion and respect are prominent and clear."
Oct. 13: The Oregonian reported the Oregon Justice Department has opened an investigation into Providence's financial practices. The department's consumer protection arm is leading the civil investigation, a spokesperson told the news outlet. The spokesperson declined to provide details on the subject and scope of the investigation.
"Our charity care policy exceeds the requirements under Oregon state law," a Providence spokesperson told Becker's in response to the investigation, adding that it was the first healthcare system to sign on in support of a 2019 bill that set minimum amounts that nonprofit health systems are required to spend on patients who cannot afford medically necessary treatment. That bill took effect in 2020.