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Christian Healthcare Employer Dodges $900K Bill for Premie Baby

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How One Employer Stuck a New Mom With a $898,984 Bill for Her Premature Baby

(Propublica) — Lauren Bard opened the Dignity Health hospital bill this month and her body went numb. In bold block letters it said, “AMOUNT DUE: $898,984.57.”

Last fall, Bard’s daughter, Sadie, had arrived about three months prematurely; and as a nurse herself, Bard knew the costs for Sadie’s care would be high. But she’d assumed the bulk would be covered by the organization that owned the hospital where she worked: Dignity Health, whose marketing motto is “Hello humankindness.”

She would be wrong.

Bard, 30, had been caught up in an unforgiving trend. As health care costs continue to rise, employers are shifting the expense to their workers — cutting back on what they’ll cover or pumping up premiums and out-of-pocket costs. But a premature baby, delivered with gaspingly high medical claims, creates a sort of benefits bomb, the kind an employer — especially one funding its own benefits — might look for a way to dodge altogether.

Bard, distracted by her daughter’s precarious health and her own hospitalization for serious pregnancy-related conditions, found this out the hard way. Her battle against her own employer is a cautionary tale for every expectant parent.

Bard’s saga began, traumatically, when she gave birth to Sadie at just 26 weeks on Sept. 21, 2018, at the University of California, Irvine Medical Center in Southern California. Weighing less than a pound and a half, tiny enough to fit into Bard’s cupped hands, Sadie was rushed to the neonatal intensive care unit.

Three days after her birth, Bard called Anthem Blue Cross, which administers her health plan, to start coverage. Anthem and UC Irvine’s billing department assured her that Sadie was covered, Bard said.

But Dignity’s plan, like many, requires employees to enroll newborns within 31 days through its website, or they won’t be covered — something Bard said she didn’t know at the time.

Meanwhile, believing that everything with her health benefits was on track, Bard spent nine of those first 31 days recovering in her own hospital bed and then had to return to the emergency room because of a subsequent infection. She spent as much time as she could in the neonatal intensive care unit, where Sadie, in an incubator, attached to tubes and wires, battled a host of critical ailments related to extremely premature birth. At times, doctors gave her a 50-50 chance of survival.

“Right from birth she was a fighter,” Bard said.

Then, eight days past the 31-day deadline, UC Irvine’s billing department alerted Bard to a problem with Sadie’s coverage. Anthem was saying it could not process the claims for the baby, who was still in the NICU.

Bard, an emergency room nurse at St. Bernardine Medical Center in San Bernardino, called Dignity’s benefits department and made a sickening discovery. Sadie wasn’t enrolled in its health plan. It was too late, she was told, she could no longer add her baby.

Dignity bills itself as the fifth-largest health system in the country, with services in 21 states. The massive nonprofit self-funds its benefits, meaning it bears the cost of bills like Sadie’s. And it doesn’t appear to be short on cash. In 2018, the organization reported $6.6 billion in net assets and paid its CEO $11.9 million in reportable compensation, according to tax filings. That same year, more than two dozen Dignity executives earned more than $1 million in compensation, records show.

Dignity is also a religious organization that says its mission is to further “the healing ministry of Jesus.” Surely, Bard remembering thinking, they would show her compassion.

Bard made a collage of her daughter’s traumatic first days. Sadie was delivered about three months premature and spent 105 days in the neonatal intensive care unit. (Arlene Mejorado for ProPublica)

With the specter of the bills hanging over her, Bard said she literally begged Dignity to change its mind in multiple phone calls, working her way up to supervisors. She thought she’d enrolled Sadie by calling Anthem she told them. It was an innocent mistake.

The benefits representatives told her information about the 31-day rule was in the documents she received when she was hired. It didn’t matter that it was six years earlier, long before she dreamed of having Sadie, she said. The representative also told her it wasn’t just Dignity’s decision, the Internal Revenue Service wouldn’t allow them to add the baby to the plan.

Under Dignity’s plan, Bard could have two written appeals. She got nowhere with either of them. “IRS regulations and plan provisions preclude us from making an enrollment exception,” Dignity wrote in its Nov. 30, 2018, response to her first appeal.

IRS officials said they can’t talk about specific cases because of privacy issues and could not comment in general in time to meet ProPublica’s deadline.

Dignity rejected Bard’s second written appeal in a July 8 letter, saying the deadline was included in a packet sent nine days before Sadie’s birth. But at that time, Bard had already been admitted to the hospital because of complications. Dignity’s letter said it “cannot make an exception to plan provisions.”

But the federal regulator of Dignity’s plan said such plans can, in fact, make exceptions. An official with the federal Labor Department, which regulates self-funded health benefits, told ProPublica that plans can make concessions as long as they apply them equally to participants. Plus, federal law allows plans to treat people with “adverse health factors” more favorably, the official said.

Bard scrambled, futilely, to see if any publicly funded insurance plan would be able to cover the costs. Meanwhile, the bills began arriving: $206 in November, $1,033 in January, $523 in February and $69,362 in April, with the biggest yet to come. Sadie had spent 105 days in the hospital and had several surgeries — and the bills would be Bard’s alone.

Sadie’s total hospital tab was nearing $1 million and climbing when ProPublica first spoke to Bard. “I’ll either work the rest of my life or file for bankruptcy,” she said.

Bard said she and her fiancé — Sadie’s father, Nathan Benton — considered delaying their wedding so he wouldn’t be legally saddled with the bills as well.

Bard went numb when she opened this bill from the University of California, Irvine Medical Center and saw the amount due: $898,984.57. (Arlene Mejorado for ProPublica)

The looming debt, and her employer’s rejection, sent Bard reeling when she was already suffering from postpartum depression. She went back to her job while worrying that she might lose her home in Norco. She wept and beat herself up again and again about missing the deadline: How could she not think of something like that? She should’ve known. She should’ve been on top of it more.

Anthem declined to comment for this story. UC Irvine, where Bard said the care was excellent, said that cases like Bard’s are unusual but may happen in 1% to 2% of births. The hospital tries to work with patients when they get stuck with the bills, a UC Irvine spokesman said.

With the appeals exhausted, the $898,000 bill landed. Bard could see right away that handling it the typical way, with a payment plan, was not going to work. If she chipped away at it at $100 a month, settling the obligation would take more than 748 years. “It would take so long I’d be dead,” Bard said.

Bard could see no way out. On Oct. 7, she posted a photograph of the $898,000 bill on Facebook. “When Dignity Health (the company I work for) screws you out of your daughter’s insurance…” she wrote.

A week later, ProPublica, which had been flagged to Bard’s case while reporting about health insurance excesses, contacted a Dignity media representative.

The next day, Bard got a call from the senior vice president of operations for Dignity Southern California, who apologized and said she’d heard about the situation from the organization’s media team and would help. Two days later, Dignity added Sadie to the plan, retroactive to her birth date. It would cover the bills.

Dignity officials told ProPublica that they’d learned about Bard through her Facebook post. Bard said she doubts Dignity would have reversed course without the questions from ProPublica.

Bard holds Sadie, now 13 months old. She is healthy and reaching developmental milestones. (Arlene Mejorado for ProPublica)

Dignity said in a statement that it would review how it could better educate new parents about the enrollment requirement. But Bard still wants to know why her employer would make her suffer through such an ordeal. In a letter Bard received last week, the Dignity benefits department said it had received additional information that caused it to reverse course, but it appears to be the same information that Bard had been telling it all along.

“We based this new decision on certain extenuating and compelling circumstances, which, in all likelihood prohibited you from enrolling your newborn daughter within the Plan’s required 31-day enrollment period,” the letter said.

Bard recognizes a dark irony in her Christian employer’s behavior, and it’s made her skeptical. She urged the benefits department to change its process so other employees don’t also have their benefits denied. Dignity needs to put its own ideals into practice, she told ProPublica. “You can’t put on this facade,” Bard said. “You have to live it. You have to walk the walk.”

Bard said she and Benton still don’t know the final total for Sadie’s care. But they sometimes call the sassy and dimpled 1-year-old, who is healthy and reaching developmental milestones, their “million-dollar baby.”

ProPublica is an independent, nonprofit newsroom that produces investigative journalism with moral force. We dig deep into important issues, shining a light on abuses of power and betrayals of public trust. Follow on Twitter at @ProPublica 

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Public Health Updates From LA County on Novel Coronavirus

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LOS ANGELES — The Los Angeles County Department of Public Health recently hosted a press briefing to provide an update on the 2019 novel coronavirus (2019-nCoV) and the interagency work being done to identify and assess travelers who may have been exposed to the virus.
 
A significant number of resources across Los Angeles County are focused on protecting the public’s health at large,” said Barbara Ferrer, PhD, MPH, MEd, Director of Public Health.

“To date, there have been no reported coronavirus cases in LA County and currently the risk of local transmission is low according to the Centers for Disease Control and Prevention (CDC). We will keep everyone informed as more information becomes available. We are urging the public to remain calm, as it is very unlikely that they are at risk of contracting this virus,” she added.
 
The CDC announced the first case in the United States on January 21, 2020. Recently, hundreds of cases of pneumonia associated with a novel coronavirus in Wuhan City have been identified.

Public Health will continue assisting the CDC to ensure that travelers who may have visited Wuhan City that have a fever or respiratory illness symptoms are appropriately screened, tested and receive care. Travelers who have visited Wuhan City who are not ill upon their arrival to the LA County are advised to contact a healthcare provider and seek care if they become ill while here.

While there is no cure for this virus, hospital partners and clinical providers are able to test and care for ill travelers to minimize transmission and treatment for symptoms.
 
Health care professionals have been reminded to use meticulous infection control practices at all times.  Public Health will continue to provide updated information about the diagnosis and management of cases of novel coronavirus to health care providers and all hospitals in the County in an effort to identify and contain any future cases.

About Coronavirus

Coronaviruses are zoonotic, meaning that they cause infections that usually exist exclusively in animals but can be transmitted to humans. However, some coronaviruses are also able to be transmitted from person to person, like SARS and MERS, while others are not.

While there is no specific cure for infections caused by the novel coronavirus, hospital partners and clinical providers are able to provide care for symptoms caused by the infection. Symptoms include:

  • Fever
  • Cough
  • Difficulty breathing

People who have traveled to Wuhan, China since December 1, 2019, could have been exposed to the virus. Seek medical care if you traveled to Wuhan and develop a fever and fever or respiratory symptoms within 14 days of your return. We want to underscore that there is no need to exclude anyone who has traveled to or from Wuhan City, or China in general, unless they are symptomatic, at which time they should seek a medical evaluation.
 
There is much more to learn about the transmissibility, severity, and other features associated with this novel coronavirus, and investigations are ongoing in China and at least five other countries.
 
For more information about 2019 novel coronavirus (2019-nCoV) visit  publichealth.lacounty.gov, or call 2-1-1.


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LA Public Defender Leads $1.2 Million Grant to Help Mentally Ill

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LOS ANGELES — The LA County Public Defender’s Office is the lead agency for a $1.2 million grant to divert people suffering from mental illness out of jail and into treatment.

LA County has been awarded the two-year grant from the MacArthur Foundation to directly address the over-incarceration of the mentally ill.

Los Angeles County operates the world’s largest jail system and its jails remain critically overcrowded. One of the main drivers of the local jail population is the incarceration of the mentally ill.

The grant will allow the Public Defender’s Office, working with other County and City agencies, to expand pre-plea diversion for those in custody as a result of a mental disorder. The effort will work toward breaking the cycle from medical and mental health facilities to custody, with a focus on the homeless population.

“Mentally ill people do not belong in jails,” LA County Public Defender Ricardo D. García said. “The startup funding provided by the MacArthur Foundation represents a substantial opportunity to mitigate the counterproductive use of criminal courts and jails as holding centers for the mentally ill men, women and children of Los Angeles County.”

This new initiative will include embedding mental health professionals in high volume courtrooms, same-day assessments of defendants who appear to suffer from a mental health disorder, and the pre-plea release and diversion of qualifying individuals into mental health treatment programs.

To help guide the launch of this program, the initiative will utilize provisions of AB 1810, a state law enacted in 2018 that allows pre-plea diversion for some defendants with mental health needs.

Partner agencies in this endeavor include the Los Angeles County Alternate Public Defender; Los Angeles City Attorney’s Office; Department of Mental Health; Sheriff’s Department; Department of Probation; Department of Public Health; Health Agency Departments; County Counsel’s Bail Reform Team; Project 180, with support from the Superior Court.

The $1.2 million MacArthur grant will go toward diverting people suffering from mental illness out of jails and into treatment.

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L.A. Teachers Sue Delta Airlines for Fuel Dump on Elementary School

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L.A. Teachers Sue Delta Airlines for Fuel Dump on Elementary School

LOS ANGELES — Delta Airlines just got hit with a lawsuit because one of its jets allegedly dumped fuel on an L.A. elementary school.

Video showed Delta flight 89, a Boeing 777 bound for China, turning back to LAX Tuesday to make an emergency landing, and spewing fuel as it went in preparation for landing. Unfortunately, that fuel ended up dousing children at Park Avenue Elementary in the city of Cudahy, CA.

Four teachers at the school have hired Gloria Allred to take on Delta. In the suit, obtained by TMZ, they say the pilot was asked by air traffic control if there was a need to dump fuel before landing … and the pilot said no.

The suit alleges the pilot dumped the fuel without notifying the control tower … and the big problem is … it was done at an altitude of about 2,000 feet. According to docs, that’s simply too low to allow the fuel to evaporate before it reaches the ground — it should be done at 5,000 feet or higher.

In the suit, the teachers say their clothes, flesh and eyes were coated in jet fuel — and it also got into their mouths. They say they had trouble breathing and needed medical treatment.

They’re suing Delta for negligence … and seeking damages.

Tune in to TMZ on TV weekdays Monday through Friday (check syndicated/local listings)


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