CHS Sues Thousands of Patients; Hospital Parking Fees Under Fire; Trump-Era Emails

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Hospital Chain Blasts Patients With Lawsuits During Pandemic

Community Health Systems (CHS), one of the 10 largest hospital chains in the U.S., filed at least 19,000 lawsuits against individual patients since the start of the pandemic in March 2020, a CNN investigation found.

Patients were sued for unpaid bills as low as $201, though CHS pursued amounts up to $162,000, according to CNN. Because most patients did not fight their lawsuits, the court would generally rule by default in favor of CHS, which allowed for liens on patient property or garnishment of wages, depending on state regulations.

The move comes despite the fact that 2020 was the company’s most profitable year in a decade, with its top executives earning millions in bonuses. CHS also received $705 million in pandemic-related aid from federal, state, and local programs in 2020.

CHS said in a statement it only sues a “small fraction” of the patients it treats every year, that “legal action is always the last resort,” and that it only files lawsuits against patients who can afford to pay. Patients and their lawyers said the company’s “rhetoric doesn’t always hold up,” and patient advocates said that the company uses “hardball collection tactics,” according to CNN.

“I can’t think of a worse thing a hospital system can be doing than suing patients for medical bills during a pandemic and a recession,” Caitlin Donovan, spokeswoman for the National Patient Advocate Foundation, said in the article.

Parking Fees a ‘Knife in the Back’ for Cancer Patients

The injustice of racking up significant parking costs while being treated for cancer is starting to get attention from oncologists and even some hospital administrators, according to Kaiser Health News.

Some hospitals don’t validate parking for patients with cancer, and those fees can stack up to about $1,680 over the course of treatment — excluding follow-up appointments, blood draws, routine scans, and immune-boosting injections — according to a short study cited in the article.

The study, published in JAMA Oncology last July, became the most read and downloaded article in that journal last year.

It also received a large response on social media. Out of 63 hospitals included in the study, only 20 provided free parking to patients with cancer.

Beyond financial hardship, parking fees can also stand in the way of participating in a clinical trial, KHN reported. While some charities provide travel grants or financial aid, “Charging cancer patients for parking is like a knife in the back…. We can’t control copays, but we can control what patients pay for parking,” Vijay Trisal, MD, a surgical oncologist and chief medical officer of City of Hope National Medical Center in Los Angeles, said in the article.

Trump-Era FDA Email Revelations

A cache of Trump administration-era emails released by the FDA reveals celebrities and other well-connected business people competing for the agency’s attention, frequently on things that ultimately failed, like hydroxychloroquine.

The emails — about 500 pages of them — were released in response to a Freedom of Information Act (FOIA) request by Endpoints News.

For instance, in late March, Dr. Oz asked coronavirus task force coordinator Deborah Birx, MD, to secure enough hydroxychloroquine for clinical trials he planned to run and pledged $250,000 of his own money to make those trials happen.

Conservative television host Laura Ingraham forwarded allegations that a New York hydroxychloroquine trial was using vitamin C as a placebo to make HCQ look ineffective — but Stephen Hahn, MD, the FDA Commissioner at the time, pointed out no such trial existed.

The emails also revealed White House aide Hope Hicks trying to get Hahn’s attention for a product from a California doctor called “Cell Armour” to treat COVID-19. There were also questions raised about potential document leaks.

Convalescent plasma was cited more than once, revealing an angry Peter Marks, MD, FDA’s top biologics official, who “railed against” a leak from the NIH that may have held up emergency authorization of the therapy.

There was also revelation about Hahn’s ill-fated encounter with a mortality statistic regarding the therapy. While Hahn claimed he misspoke about a 35% overall reduction in mortality, the email suggests he was “planning to make the inflated claim all along,” Endpoints reported.