As two states consider regulating hospital prices for uninsured patients, Florida hospitals have launched a counterattack against hospital critic K.B. Forbes in which they accuse his Latino advocacy group of being a front for the insurance industry.
Forbes, director of Los Angeles-based Consejo de Latinos Unidos, which recently prodded hospital chain Tenet Healthcare Corp. into reducing its prices for uninsured patients regardless of income, has made Florida hospitals his latest target.
Last week, Forbes unveiled his third television ad in Tallahassee, Fla., accusing hospitals in the state of economic discrimination for charging significantly higher prices to people without insurance. The ad depicting a sobbing Latina with the words, "Florida Hospital Association ... Aren't you proud?" was unveiled at a news conference on the same day the Florida Legislature took up a bill to cap hospital charges.
The Florida Hospital Association is pressuring Forbes to reveal where he's getting money for the media blitz, as well as travel and legal expenses. Consejo's most recent Form 990, its tax filing with the Internal Revenue Service for 2002, showed revenue of $76,156 and an ending balance of just $2,113.
"In the interest of fairness and openness, it's time for you to give a complete accounting of your relationship with insurance companies and political organizations," association Senior Vice President Ralph Glatfelter said in a statement earlier this month.
Jim Thomison, a Sarasota, Fla., lawyer who represents hospitals in billing disputes with insurers, told Modern Healthcare that he has "no doubt there is a direct connection" between Consejo and insurers. "What's going on here is an attempt by the insurance industry to unilaterally reduce payments to hospitals," Thomison said.
Hospitals point to Forbes' acknowledgement to the Miami Herald in January that he received $100,000 in start-up money from a foundation controlled by J. Patrick Rooney, chairman and CEO of Medical Savings Insurance Co., which sells medical savings accounts. The Indianapolis firm is a defendant in a class-action lawsuit filed by Florida hospitals last year that alleges the company consistently underpaid hospitals for services.
Medical Savings Insurance said it filed an antitrust suit against the Florida Hospital Association and at least three hospital systems in the state this month, blaming exorbitant hospital charges for a drop in its sales. "Overpricing by hospitals hurts the marketability of health savings accounts," said Alan Nisberg, the company's lawyer.
Forbes has said he never spent Rooney's money or received funds from insurance companies or political groups. He is keeping his contributors anonymous to shield them from retaliation. "We're proud to help people, not politicians or egos," Forbes said. He said hospitals are questioning his tactics to "deflect attention from their own egregious behavior."
The hospital association said the attack ads violate Consejo's articles of incorporation, filed in October 2001, which say the group won't attempt to influence legislation. As a public charity, Consejo is limited in the amount of money it can direct toward lobbying.
Pending legislation would benefit insurers by setting a precedent for state price-fixing and lowering rates for non-negotiated services, said Florida Hospital Association spokesman Rich Rasmussen. A bill introduced in January originally would have required 30% discounts for uninsured patients, but it was amended to cap hospital charges at 200% of Medicare rates. Spokesmen for the Florida association and the American Hospital Association said tying rates for uninsured patients to Medicare rates isn't only unfair for hospitals but also wouldn't work because Medicare doesn't cover all services.
The bill was approved by a Florida House committee last week and has yet to be considered in the state Senate.
The Illinois Senate passed a bill last week that would require hospitals to provide free care to uninsured patients who earn no more than the federal poverty level and to provide care at cost to uninsured patients with incomes of up to twice the federal poverty level. It would bar collections lawsuits within 70 days of care and require patients to provide financial information in order to qualify for free or discounted care and to comply with payment plans.
Hospitals in several states have implemented voluntary guidelines for offering free or discounted care to the uninsured. Connecticut requires hospitals to provide care at cost to patients who earn no more than 250% of the poverty level. Massachusetts hospitals must provide free care to patients who earn up to 400% of the poverty level.