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UNC Health Care Draws Fire in Attempt to Recover Unpaid Bills

Legal action taken by a state-owned hospital system in North Carolina has sparked criticism from politicians, academics and medical professionals. In an attempt to recoup approximately $16 million in unpaid medical expenditures, UNC Health Care – through the state Attorney General’s Office – has filed complaints against more than 2,300 patients. One of the patients is 61-year-old Jerry Ansley, who had a lien placed on his family’s home in Clayton, NC. Ansley was treated at UNC over the course of several months in 2004 for a debilitating case of viral encephalitis likely contracted from a mosquito bite. He subsequently developed a rare case of acquired hemophilia, most likely from an immune system response triggered by encephalitis.

UNC Health Care, a not-for-profit integrated healthcare system based in Chapel Hill, claimed that Ansley owed the state hospital $185,300, the amount listed on his financial aid as the value of his home.

During the course of his treatment, Ansley received many doses of the recombinant factor VII drug NovoSeven® to stem severe bleeding. NovoSeven® is manufactured by the pharmaceutical company Novo Nordisk. Although Ansley and his wife Kathie had health insurance, it did not cover the mounting medical bills that quickly grew to hundreds of thousands of dollars. In an attempt to pay their outstanding medical bills, the couple emptied their retirement savings.   

A grant awarded by the Novo Nordisk Foundation seemingly eliminated much of the drug cost, while the hospital’s financial aid department agreed to waive other hospital fees. Despite this assistance, Ansley was still considered a debtor by UNC and a legal dispute ensued between it and the Ansley family. As a state-owned entity, UNC is obligated by state law to make an effort to obtain payments from debtors.      

In response to UNC’s tactics, a petition drive was initiated in part by John Hammond, a retired professor of medicine at UNC-Chapel Hill. The purpose of the petition was
 to remind the healthcare system of its mission to care for all patients regardless of their ability to pay. 

“It just seems incongruous that a hospital founded on improving the health of all North Carolinians is the most aggressive in collecting debt from those who appear least able to pay,” Hammond said.

UNC’s Chief Executive William L. Roper, MD, MPH, explained the rationale behind the hospital’s effort to cover outstanding costs. “We are anxious at every turn to see that we are treating people fairly and with compassion, but we need to collect the money that we can collect so we can continue to provide free care.” He said that in the future UNC patients who either qualify for financial aid or make an honest effort to pay medical bills will not be pursued by the Attorney General for collection. The News & Observer recently reported that the Attorney General’s office has dismissed the case against the Ansleys.

The experience had a profound effect on Ansley. “It freaks me to even go near a hospital today,” he said. “If I see an ambulance go by I say, ‘Thank heaven it's not for me.’”

Source: The News & Observer, September 10th and 23rd 2006


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