Suits inflict fresh wounds

Hundreds of times a year, Carolinas HealthCare System files lawsuits to collect from hospital patients who don’t pay their bills. Some of those sued have little income and no health insurance. Here are four of their stories:

Cancer patient: Lawsuit made tough situation worse

In 2012, Karen Roberson’s life began to unravel. The east Charlotte resident was working as a home care nurse early that year when she was diagnosed with breast cancer. After she took sick leave from her job, her employer fired her – and canceled her health benefits. Roberson’s bills for chemotherapy at CMC-NorthEast quickly piled up.

Her son, Davey, said he filled out an application for charity care from the hospital and followed up repeatedly to see whether his mother had qualified. But no free care was offered.

It’s unclear why not. The hospital system declined to discuss individual cases.

Under Carolinas HealthCare’s charity care policy, uninsured individuals making less than about $22,000 per year in 2012 – twice the federal poverty level – could generally qualify for free hospital care. Roberson said her annual income in 2012 was well below that: about $10,000.

Collections agents began calling, sometimes as many as 10 times a day. Last year, the hospital system sued Roberson for more than $44,000 and won a judgment.

“One of the main things to beat cancer is your outlook,” Roberson said. “To have all this stuff come down on you when you’re still going through this mess, it’s very debilitating.”

Melissa Jacoby, a law professor at UNC-Chapel Hill who studies medical debt, said she thinks nonprofit hospitals have an obligation to offer reasonable payment plans to patients such as Roberson.

“This clearly shows a continued breakdown in the system,” Jacoby said. “What you’ve described is exactly the kind of patient a hospital should be working with collaboratively. … To disrupt the medical relationship with a lawsuit is very disturbing. Patients may feel discouraged from continuing the care.”

Mired in poverty, family hit with hospital lawsuit

Vickie Cuthbertson is the sort of person whom hospital charity care policies are designed to help.

She had no job and no health insurance in 2012, when she was hospitalized several times for seizures, strokes and other medical problems. She and her husband, Joe, say their family of five had annual income of just $12,000 – well below the federal poverty line. Their two-bedroom house in northwest Charlotte is valued at less than $80,000.

Under Carolinas HealthCare’s financial assistance policy, uninsured patients can qualify for free care if they earn less than twice the federal poverty level. In 2012, that amounted to less than about $54,000 for a family of five.

But no one from CMC-Mercy offered charity care – or even suggested that Cuthbertson apply for it, Vicky and her husband said.

“That’s why we have hospitals,” said Vicky, now 60. “They are supposed to help you if you need help.”

Last year, the hospital filed suit and won a judgment for more than $31,000. Vicky and her husband said there’s nothing they could have done to stop it.

“We try to pay,” Joe said. “But you can’t go without lights. Heat. Food. They don’t care. All they want is their money.”

Hospital sues cancer patient whose bills dwarfed her salary

A flurry of medical bills arrived in Janneth Guzman’s mailbox after her treatments for breast cancer in 2012.

The bills for her mastectomy, radiation and chemotherapy at Carolinas Medical Center totaled more than $200,000. She said her family of five had just $47,000 in income that year and could not afford health insurance.

While she got discounts on her hospital treatment, she did not receive free care.

Under Carolinas HealthCare’s financial assistance policy, an uninsured family of five was generally eligible for free care in 2012 if it had less than $54,000 in income.

Guzman’s family earned more in 2011 – about $55,000. But by 2013, her family’s income had dropped to about $45,000.

She said no one from the hospital informed her about the availability of charity care or invited her to apply for it.

Carolinas HealthCare sued and won a $109,000 judgment against Guzman. In doing so, it obtained a lien on her family’s 1,300-square-foot house near South Boulevard.

Overwhelmed by her medical bills, Guzman filed for bankruptcy last year.

“What happened to me is very, very unfair,” she said.

Adam Linker, co-director of the North Carolina Justice Center’s Health Access Coalition, noted that one of the goals of the federal Affordable Care Act is to prevent catastrophic medical bills from bankrupting people.

In Guzman’s case, Linker said, “CHS is not helping to achieve that vision.”

‘We feel we got a raw deal here,’ uninsured patient says after suit

For Richard and Daniese Ingram, times were tough in 2012. Their family of three had no health insurance and less than $22,000 in income that year. They were surviving with the help of food stamps.

Richard Ingram, meanwhile, was facing a serious health threat: a painful tumor in his neck.

When he went to Carolinas Medical Center for surgery to remove the benign tumor, Daniese recalled, officials said the family’s lack of insurance wouldn’t be an obstacle: The hospital would come up with a suitable payment arrangement, and the family might even qualify for Medicaid.

Hospital officials asked Daniese many questions about the family’s finances. But no one mentioned or offered charity care, the couple said.

Now they question why.

Under Carolinas HealthCare’s financial assistance policy, uninsured patients can qualify for free care if they earn less than twice the poverty level.

For a family of three, that was equivalent to earning less than about $38,000 a year in 2012.

The bill for Richard’s outpatient surgery came to more than $22,000, after a discount that the hospital system provides to the uninsured.

Daniese said she and her husband wanted to pay $100 a month, but hospital officials rejected that offer. The hospital insisted that the bill be paid off in 18 months, she said. That would have required payments of more than $1,000 a month – well beyond the family’s reach.

Soon, bill collectors were calling. A lawsuit followed, and the hospital system eventually got a judgment and a lien on the Ingrams’ three-bedroom house in east Charlotte.

“We’re not vindictive people, but by God, we feel we got a raw deal here,” said Richard, now 52.

When Daniese was in her late 20s, doctors found pre-cancerous cells in her cervix. Now 44, she said she should be visiting the doctor regularly. But she said she hasn’t seen a gynecologist in seven years “because we can’t afford it.”

Daniese questions whether her family was treated fairly, particularly in light of seven-figure salaries for a number of top executives at Carolinas HealthCare. In 2014, for example, CEO Michael Tarwater received about $5.3 million in total compensation.

“We’re not asking for a handout,” she said. “We’re just asking for help.”

Alexander: 704-358-5060