Yakima Regional Medical and Cardiac Center and its former owner violated the state Charity Care Act by demanding payment for services from indigent patients, a judge has ruled in a partial summary judgment.

Yakima County Superior Court Judge Susan Hahn also agreed with the plaintiffs’ attorneys that the hospital’s failure to meet the terms of the Charity Care Act constituted a breach of contract between the hospital and the patients in question.

Hahn also granted a motion to compel discovery, requiring Regional to turn over certain information long sought by the plaintiffs to further bolster their case, which has class-action status.

“It’s a very, very good ruling for the class and for the plaintiffs,” said attorney Andrea Schmitt with the nonprofit Columbia Legal Services, which is handling the suit in conjunction with Seattle law firm Sirianni Youtz Spoonemore Hamburger.

The lawsuit, filed in 2013 against Regional and its former owner, Florida-based Health Management Associates, alleges that Regional actively discouraged indigent patients from seeking care by aggressively requiring payments or deposits before procedures. Documents from the hospital, released by Hahn earlier this year, show Regional employees could earn bonuses based on how much money they could wring out of self-pay patients, and were subject to scrutiny or discipline if they failed to reach certain monetary targets.

Regional's current owner, Community Health Systems, which inherited the liability posed by the lawsuit, has consistently declined to comment on the case.

Washington’s Charity Care Act specifically requires hospitals to proactively offer at least partial charity care to any patient who falls below 200 percent of the federal poverty level, without requiring credit checks or anything else to verify patient eligibility.

In her Dec. 14 ruling, Hahn agreed that Regional “routinely” violated the Charity Care Act by requiring deposits from poor patients before screening them for charity care.

“Some overpayments were eventually refunded. Nevertheless, it is likely some indigent patients were unable to pay these deposits and as a result denied access to qualified medical services,” she wrote.

In the second piece of her ruling, given in the form of a letter that will be distilled into an official written order in the coming weeks, she shot down Regional’s argument that a violation of the Charity Care Act was not necessarily a violation of the contract between the hospital and patients.

Patient contracts demanded a certain amount of payment, which “was incorrect and the result of the Defendants’ failure to determine CCA eligibility before setting the contract payment amount,” Hahn wrote.

As to the order compelling discovery, Schmitt and the other attorneys for the plaintiffs have long been asking Regional to provide documents listing patients the hospital has taken to court over collections.

“We were just asking for, basically, a list of those actions so that we could see whether the hospital was suing people who were eligible for charity care on their debt,” Schmitt said.

The plaintiffs’ attorneys are also seeking any documentation of Regional’s efforts to meet the conditions of the Certificate of Need the hospital agreed to when HMA first purchased it from the Sisters of Providence in 2003.

That agreement required HMA and Regional to attempt to “meet or exceed” the regional average for charity care provided by hospitals.

“We just wanted to know, ‘OK, what efforts did you make to do that?’ And they resisted giving us an answer to that,” Schmitt said. “So they were compelled to tell us what they did, or tell us that they didn’t do anything.”

Department of Health records show that in 2013, Regional provided charity care worth about 1.45 percent of its total adjusted patient revenue. The regional average among hospitals in Central Washington was three times that, at 4.4 percent.

The partial summary judgment helps pave the way for the next step, Schmitt said, in which the plaintiffs’ attorneys have a claim pending that Regional’s actions violated the Consumer Protection Act by being “unfair and deceptive” in patient dealings.

This step is very important, she says, because the Consumer Protection Act allows for triple damages.

So if the plaintiffs win, they would not just be awarded the money they had paid out for medical services when they should have received charity care, but potentially triple that amount.

The next step in the case will depend on what the plaintiffs’ attorneys find in the documents that will be provided under the judge’s order compelling discovery, Schmitt says.

“We have been waiting for this step for a long time,” she said. “We don’t have another motion on the calendar yet, but we’ll move forward quickly. We want to keep momentum here and get folks some relief.”

“We got into this case because we think it’s essential that hospitals treat patients who are suffering, regardless of how much money they make, and that they not work to deny them care or to squeeze them for money that they can’t afford to pay,” Schmitt continued. “So we’re very pleased with this ruling.”

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