A small band of University of Virginia students stood outside of McKim Hall on Monday to call on the university’s medical center to change its aggressive debt collection procedures and to forgive patients’ existing medical debts.
As the group met with reporters outside the building, hospital officials held an employees-only town hall meeting inside to discuss collection procedures and proposed changes.
The medical center’s billing and debt collection practices were called out last week in a Kaiser Health News report that revealed the health system and its doctors had sued former patients more than 36,000 times for more than $106 million from 2013 to June 2018.
The medical center seized wages, bank accounts, put liens on property and homes and forced many families to file for bankruptcy. The center also prevented students whose medical debt was in arrears from registering for classes until debts were paid.
The report, and resulting national publicity, led university officials to announce new guidelines to write off more bills of low-income patients and to offer uninsured patients a larger discount if they meet new asset requirements.
Officials did not address whether it will add additional assistance for the unemployed or its own staff or for students.
“A lot of my friends have incredible health problems, and their families have incredible medical debt that they’re struggling with,” said Sekum Appiah-Ofori, a first-year student. “Hearing about the practices they’ve been using made me want to come out and help stop what they’re doing.”
“I think the stories about the debt collection practices were horrific,” said Jake Wartel, a second-year student. “There are people who get medical treatment to live and our own university is pursing debt collection so aggressively that people [go bankrupt]. It shows the corrupt nature, the greedy nature of the university and health care industry.”
The students, members of the university’s Young Democratic Socialists of America, called on the university to change its methods and on Congress to create a single-payer system of medical care. A form of that concept is currently being bandied about on the Democratic Party presidential campaign trail as “Medicare for All.”
“We need Medicare for All so that people can get the health care they need,” said Madison Perry, a second-year student who said she has a friend whose family cannot afford to pay a $7,000 charge to remove the mother’s skin cancer.
Perry also talked about a fellow student who faces a registration hold at UVa because she has been unable to pay a medical bill in full that she incurred due to a car accident.
“That UVa profited off an individual’s treatments shouldn’t be a surprise,” she said. “The only way we will see justice is if medical organizations don’t profit from treatments.”
In a statement released Friday, UVa medical officials said from now on they will refrain from filing suit unless patients have outstanding balances over $1,000 and are part of households earning more than 400% of the federal poverty level, which is $103,000 for a family of four.
Medical center officials noted that a state law requires that officials try to collect those debts that it can.
Currently, UVa writes off medical debts for the small fraction of patients at or below the federal poverty level with less than $3,200 in assets. An individual making less than $12,500 or a family of four making less than $25,750 are considered to be living in poverty.
UVa’s current asset test asks patients to list retirement, savings and investment accounts but excludes a home, a car and up to 3.99 acres of land. Under new guidelines to take effect on Jan. 1, the medical center will increase the amount of a bill to be written off rather than collected depending on income and assets of patients.
Doug Lischke, the hospital’s chief financial officer, said on Friday that the hospital had considered adjusting its guidelines before but seriously started investigating the possibility after reporters’ inquiries.
The town hall was held to explain the changes announced last week to employees and to get their input, said Eric Swensen, hospital spokesman. Others were held last week, and more will be scheduled.
“This is the first step toward addressing the situation,” he said, noting that officials plan to create focus groups with employees, officials and patients to work on fair and equitable billing and collections.
“There are a couple of things we need to try and balance, including the state law, and we have to do a better job of balancing those things,” Swensen said. “We’re going to keep working and moving forward with this.”