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November 12, 2019

Research IDs CT’s most litigious hospital; thousands of patients sued annually

Photo | Danbury Hospital Danbury Hospital

It appears that one Connecticut hospital stands alone when it comes to pursuing patients in small claims court over unpaid medical bills, according to a new analysis from a UConn Health researcher.

Danbury Hospital was responsible for nearly half of the 13,824 total medical debt cases filed in 2016 in the state. That was up from 2015, when Danbury filed 39 percent of the total 11,747 cases, according to Dr. Victor Villagra, who compiled the analysis from a trove of state Superior Court data he obtained through a Freedom of Information Act request.

Villagra has not yet obtained full-year data beyond 2016, but in response to his report, Danbury Hospital -- a member of of Western Connecticut Health Network (recently renamed Nuvance Health) -- told HBJ that it’s reviewing its debt-collection policies.

Danbury Hospital spokesperson Andrea Rynn said that the not-for-profit hospital provides care around the clock to anyone who needs it, regardless of ability to pay, and said the hospital provided $13.3 million in free care to those in poverty last year.

“During that same year, of our hundreds of thousands of encounters, approximately 0.2% led to court filings and only after months and even years of outreach through letters, statements and phone calls -- all asking if the patient needed financial assistance go ignored,” she said. 
“However, we realize this can be overwhelming for some and so we are currently reviewing our policy,” she added. “We continue to encourage any patient facing financial hardship to reach out to our billing office for assistance.”

Villagra, associate director of the UConn Health Disparities Institute, published some of his Connecticut debt collection research over the summer, revealing that in-state hospitals and other providers had filed more than 85,000 collection lawsuits between 2011 and late 2016, claiming they were owed more than $110 million over that period, with most of the outcomes going in the plaintiffs’ favor.

However, Villagra did not in that June paper reveal who the biggest plaintiffs were. He did so recently in a presentation to the High Deductible Health Plan Task Force, which was convened by the state legislature this year to study how rising deductibles are affecting patients in the state.

Providers have complained to the legislature that high deductible plans result in large medical bills to patients, some of whom are unable to pay, thus forcing doctors and hospitals into the position of being collections agents.

Villagra shares concerns about HDHPs, and has been critical of the cost and complexity of health insurance policies and the potential of those factors driving disparate outcomes for minority groups.

His Superior Court dataset understates the amount of medical debt actions in the state because it does not capture legal claims for medical debts larger than $5,000. He said state court officials told him they were unable to provide that data. It also does not capture non-hospital medical debt lawsuits, such as those filed by standalone physician groups.

Danbury Hospital told the state Office of Health Strategy last year that it systematically refers account balances of under $4,999 to a collection agency after issuing a final notice to the debtor. In 2018, the hospital recovered just over 23 percent of the dollar amounts it had assigned to a collection agency.

The OHS filing doesn’t give the dollar amount, but Villagra’s data show that debts claimed by the hospital in 2016 lawsuits totaled $8.8 million. That compared to $10.4 million claimed in lawsuits filed by all other Connecticut hospitals that sued patients for medical debt that year, his report said.

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