Delivery of Care

The metrics of debt

How does a patient calculate the proof of bad medical practice, poor quality medical devices, and the high cost of pain?

Photo by Richard Asinof

A portrait of the reporter afer neck surgery at St. Elizabeth's Hospital in Brighton, Mass., a Steward Health Care facility, three days post surgery.

By Richard Asinof
Posted 8/19/24
In the next week, ConvergenceRI must decide whether or not to file a proof of claim in federal bankruptcy court in Houston, Texas, as a protection of my rights as a patient whose quality of health care may have been jeopardized by the willful failure of Steward Health Care to pay its medical bills.
What would be the consequences of the executives at Steward Health Care being held accountable for their actions and their alleged criminal behavior, hearing what former Los Angeles City Attorney Ira Reiner once described as “the slam of the jail door behind them?” Would Rhode Island Monthly ever consider running a special edition of its magazine featuring not the best doctors in Rhode Island, but a list of the doctors and nurses who had been found guilty of having committed Medicare, Medicaid and health insurance fraud, replete with glossy photos?
The recent actions taken by the Rhode Island Attorney General to crack down on illegal fees being charged by parking garages on unsuspecting customers may lead to further investigations into how the City of Providence has hired a vendor to serve as a debt collector regarding alleged unpaid parking tickets, resulting in vehicles being booted and drivers being charged large sums to remove the boot. In the same way that some unscrupulous debt collectors have purchased the alleged unpaid medical debt from patients and attempted to pressure the patients to make payments, a similar kind of unscrupulous practice may be part of the efforts by the Smiley administration to monetize the flow of cash into the city’s coffers, targeting those who most likely to be unable to contest the allegations.

PART Two

PROVIDENCE – Last week, ConvergenceRI received not one, not two, but three “Notice of Deadlines for Filing Proofs of Claim.”

“You are receiving this notice regarding the chapter 11 cases of Steward Health Care System LLC and certain of is affiliates, as debtors and debtors in possession (collectively, the “Debtors”), because you are a current or former patient of the Debtors,” the letter began, in what could be said to be calculated legal prose.

Each of the three letters continued: “This notice is to inform you that August 23, 2024 at 5:00 p.m. (Central Time) is the deadline to file proofs of claims against the Debtors in the chapter 11 cases. This date is known as the ‘General Bar Date.’

The letter then continued: “Although you are receiving this notice it does not mean you have a claim or need to file a Proof of Claim. You do not need to file a Proof of Claim for any refund arising in the ordinary course of business that the Debtors have been previously authorized to pay by order of the Court. If you believe that you have other claims against the Debtors, you may need to file a separate Proof of Claim, as patients are generally not listed as creditors in the Debtor’s schedules of unsecured claims required to be filed with the Bankruptcy Court.”

The next paragraph in the letter makes clear that there may be consequences if a claim or a proof of claim is not filed. “Under the Bar Date Order, entered by the Bankruptcy Court on July 11, 2024 at Docket No. 1564, any person or entity (other than a Governmental Unit) that holds a claim against he Debtors that arose before May 6, 2024, must file a proof of claim on or before the General Bar Date. Any person or entity that is required, but fails, to file a proof of claim (a “Proof of Claim”) on or before the General Bar Date will be forever barred from asserting such claim against the Debtors, and will be barred from receiving any distribution or vote in the Debtors’ chapter 11 cases with respect to such claim.”

What does this mean?    
Translated, the letters appear to be a legal way for the debtors, in this particular case, Steward Health Care, to protect themselves from liability for any future claims held against them by patients who received health care from a physician whose firm was owned by Steward Health Care or at a facility owned and operated by Steward Health Care, if such a claim was not mailed by Friday, Aug. 23, 2024. The return address for the legal notice had been sent by the Kroll Restructuring Administration, FDR Station, PO Box 5293, New York, NY, 10150-9998.

What might such a claim potentially look like?    
It is true, I had surgery performed by a neurosurgeon from Steward Spine Specialists on Feb. 6, 2024, at St. Elizabeth’s Hospital in Brookline. [See link below to ConvergenceRI story, “Putting your own life at risk.”] The surgery was “successful,” although the surgery had been delayed for six months because the prior authorization firm deployed by my health insurer had canceled the scheduled surgery three times, claiming first that the MRI being used to document the need for the surgery was out of date – it was eight months old, rather than the required six months old. Then the prior authorization firm claimed that my levels of increased pain and significant symptoms of disability had not been documented, although the prior authorization firm had never contacted my primary care provider, my physical therapist, or my neurosurgeon.

The surgery was finally scheduled after I engaged in an angry phone call with the person handling my “appeal” from my health insurer during which I had broken down in tears, sobbing.

Subsequently, four months after the surgery, I learned that Steward Health Care had allegedly reneged on its financial arrangements with at last three major neurosurgical device manufacturers and had failed to pay its bills on time, resulting in the surgeons allegedly being unable to access the highest quality devices to be implanted in my spine as part of the surgery.

The question is: Would it be legally prudent on my part to file a proof of claim that would attempt to show that the quality of the device implanted in my spine as part of the Feb. 6, 2024, surgery, was questionable, a direct result of Steward Health Care being unwilling to pay its bills on time and, as a result, potentially resulting in the use of an inferior product being implanted in my spine?

Which, of course, gets to the heart of the question implied by the headline in PART One of this story, “Let them eat invoices.”

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