Woman explains why she's suing Carle

Woman explains why she's suing Carle

URBANA – When she first went to Carle Foundation Hospital's emergency room last year with excruciating pain in her abdomen, Chrissy McCormick said she was diagnosed with an infection and sent home with an antibiotic.

Many painful months later, McCormick said, she wound up undergoing emergency surgery in connection with a large tumor near one of her ovaries.

Today, she's out of a job due to the pain that affected her ability to work. She's in serious debt, and she thinks Carle Foundation Hospital of Urbana should be held accountable.

McCormick on Monday became one of the newest plaintiffs in what has become a string of class-action lawsuits across the nation over the way the hospitals extend – or fail to extend – care to uninsured patients who can't pay.

"To me, this lawsuit isn't just about money," McCormick said Monday.

McCormick said the way she was treated by Carle hospital sends patients like her a strong message, and it's, "If you can't pay, don't come here."

Carle officials later Monday said they hadn't yet seen the lawsuit. But based on what they heard about it, they vowed to defend the hospital aggressively from the allegations.

"As a charitable organization, Carle Foundation Hospital remains focused on its responsibility to provide the highest quality health care to everyone who seeks care at our hospital," Carle officials added. "On an everyday basis, we encourage patients in need to set up payment plans and apply for discounted or no-cost care through the hospital's Community Care program."

The Carle suit was filed in Champaign County Circuit Court by the Mississippi-based Richard Scruggs law firm, which has become nationally known for suing tobacco and asbestos companies, and in the past year for also sending dozens of not-for-profit hospitals into court over their charity care policies.

Joining Scruggs in the suit was Chicago-based Clifford Law Offices and the Urbana firm of Phebus & Koester.

One of those class-action suits filed last year in federal court against Provena Health, the owner of Covenant Medical Center in Urbana and United Samaritans Medical Center in Danville, was withdrawn Jan. 10 by the plaintiffs' lawyers. But a spokesman for Clifford Law Offices said the suit against Provena will be refiled soon in state court.

The Carle suit was filed on behalf of McCormick and another former Carle patient, Monty Eveland, and unidentified uninsured people.

The suit seeks monetary damages over $50,000, and alleges Carle is violating state consumer fraud laws by charging uninsured patients unreasonable rates and failing to provide those patients an adequate opportunity to apply for charity care.

McCormick, 20, of Urbana, said she and her husband have joint income of less than $12,000 when they are both working, and they can't afford medical insurance.

She said she went to the Carle emergency room in severe abdominal pain several times last year, and in the fall a Carle emergency room doctor told her the original infection diagnosis may have been incorrect. The mass near her ovary was found in further testing.

McCormick was scheduled for surgery, but said that the day before her preoperative appointment with the doctor, she got a call from Carle telling her she would have to obtain insurance or bring $3,000 to $5,000 for her surgery. Because she couldn't comply, she said, both the appointment and surgery were canceled.

McCormick also said she is grateful for the emergency surgery she eventually obtained at Carle, but it came too late to save her job and prevent her from falling further into debt, which now includes more than $16,000 for the surgery. She said she may also have a reduced ability to have children due to the delay in the surgery.

Eveland, who couldn't be reached for comment, was identified in the suit as a laborer and mechanic with a modest income. The suit states he went to Carle hospital in 2001 for an infection from a roofing job, and wound up being hospitalized for a week at Carle when the wound became reinfected.

Eveland was billed $22,000 for his care, and has been pursued by Carle in collection actions though he called the hospital several times saying he was homeless and unable to work, the suit states.

Claudia Lennhoff, executive director of Champaign County Health Care Consumers, said her organization isn't a party to the suit against Carle – though she referred McCormick to Scruggs and has fielded hundreds of complaints from other consumers about that hospital, she said.

Lennhoff said her organization has been working with both local hospitals on their charity care and debt collection practices, and has accomplished much improvement with Provena Covenant Medical Center. But even though Carle hospital seems to have good policies in place, she added, they appear to fall apart down the line as employees interact with patients.

"My guess is the people at Carle that we meet with think things are going OK," she added. "I think there might be a disconnect between the management people and the day-to-day people who work there."

Carle officials said the hospital provided more than $2 million in no-cost and discounted care last year to more than 1,800 people. Carle spokeswoman Gretchen Robbins said the hospital also shouldered about $14 million more in community benefit services, including the AirLife medical helicopter, parish nurse program, pediatric hematology/oncology program, low vision center, breast-feeding clinic, "Having your Baby Program," and the Carle auxiliary guesthouse.

"We believe, as a not-for-profit hospital, that we have an obligation to not only serve all patients regardless of their ability to pay, but to also provide an array of services that give value back to our community," she said.

The Carle suit specifically alleges the hospital charges uninsured people rates much higher than those it charges people with health insurance and those on government assistance programs for the same services, and that the hospital has created many obstacles – including a demand for lots of paperwork – that keep people from obtaining charity care.

The lawsuit also states Carle sought 165 arrest warrants for its debtors since 1995, filed hundreds of lawsuits, garnished patients' wages, seized tax refunds and obtained judgments against former patients even after learning a patient isn't working.

"These judgments, often obtained by default, are predicated on the false representations that the charges incurred are the 'reasonable, usual and customary' rates for medical services, when, in fact, they are not," the suit states.

The suit also states Carle now has rules requiring uninsured patients to prepay a minimum of half the cost of any scheduled, elective, diagnostic or nonemergency service, and those patients with prior unpaid bills are sent away in nonemergency cases if they have a prior account that has been turned over for collection.

In addition to money damages, the suit also asks the court to order Carle to stop charging uninsured patients the highest prices, to end its restriction on charity care, and take steps to repair its debtors' credit records.

George Bellas, an attorney with Clifford Law Offices, said Carle was founded with the high purpose of helping those in the community who are in need.

"They just don't do that anymore," he said.

You can reach News-Gazette staff writer Debra Pressey at (217) 351-5229 or via e-mail at dpressey@news-gazette.com.

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