Catholic Healthcare uninsureds get 35% refund

Uninsured patients seen by Catholic Healthcare West hospitals from July 1, 2001, through September 25, 2006 are now entitled to a 35 percent discount or refund on their bill, following a ruling amending an existing class-action suit. In May, CHW had reached an agreement on the suit, which alleged that it engaged in price gouging of uninsured patients, but the new ruling restructured the payout to ensure that all affected patients received the same benefits. CHW will pay out an estimated $423 million to claimants, plaintiff's lawyers told the Sacramento Business Journal. CHW says the final number should actually be much lower, given that the estimate assumes uninsured patients all paid their bills in full. If the final agreement is approved in January 2007, uninsureds with gross household incomes of less than $250,000 per year will qualify for rates similar to the highest managed care plan rate, or a discount of 25 percent, whichever is lower. This agreement essentially gives the force of law to a policy CHW instituted in 2004 to benefit patients seen since July 2001. With charity-care suits finding some success of late, and legislators enacting curbs on cost-shifting to the uninsured, it seems likely many hospitals will have to rethink their entire billing policy over the next year or so. (Have thoughts on how they should proceed? E-mail me).

To get more detail on the decision:
- read this article from the Sacramento Business Journal

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