Sen. Charles Grassley, R-Iowa, is angry.
Grassley, who chairs the Senate Judiciary Committee, has expressed astonishment that not-for-profit hospitals garnish the wages of low-income patients who should have qualified for charity care at the institutions where they received treatment, NPR and ProPublica have reported.
A long-time critic of how many not-for-profit hospitals operate, Grassley told the publications he is astounded that some of these institutions have been systematically sending low-income patients to collections. One example is Mosaic Life Care, formerly Heartland Regional Medical Center in St. Joseph, Missouri, which uses a for-profit subsidiary to collect from patients and sue them in court. The publication interviewed one family who has been making payments at a 9 percent annual interest rate. After nearly a decade of payments, they still owe $25,000 on their medical bills.
Aggressive collections practices are not uncommon among not-for-profit hospitals, with some hiring consulting firms that undertake such tasks on their behalf.
As a result of prior reporting on the topic, Mosaic Life said it is reviewing its policies on charity care. Grassley said he wants the results of that review by the end of the month, and in a letter to the hospital called its practices "extremely punitive and unfair to both low-income patients and taxpayers who subsidize charitable hospitals' tax breaks."
Grassley helped place language into the Affordable Care Act requiring hospitals to provide more charity care, the article noted, and under those guidelines it's up to the hospitals to make a determination as to whether patients can afford to pay. Instead, he believes that Mosaic of Life shifted that burden onto the patients.
Grassley also noted in the publication that a tax exemption is not guaranteed for not-for-profit hospitals. Instead, he believes they have to "earn it" by "taking care of people who couldn't provide for their own healthcare."
He told NPR that Mosaic may have broken the law with its collection practices. And he may push to toughen language in federal charity care lines in order to guarantee that hospitals abide by the guidelines.
A spokesperson for Mosaic Life told NPR that it will respond to Grassley's request and that it's goal is to "do the right thing."