Some Medical Debt May Be Avoidable in Massachusetts

Robert Peck, a motivational speaker from Greenfield, Mass., has relied on health insurance coverage his entire adult life. He says he paid $470 per month for his insurance, plus high deductibles whenever he needed more-than-routine care.

But when Peck tested positive for a rare type of blood cancer, his insurance company refused to cover him when he needed the financial and health support the most.

"I was in total shock. I literally did not know what to do," said Peck during a conference call for reporters organized by the Access Project, a nonprofit dedicated to helping underserved communities with health care.

The nonprofit released "In Debt, But Not Indifferent," a 29-page report outlining the problem of health care-related debt of Massachusetts residents.

The report was funded by the Blue Cross Blue Shield Foundation of Massachusetts, a sponsor of EthnicNEWz.org's health beat.

At the time of Peck's cancer diagnosis, he needed more testing and potentially several visits to an oncologist, a cancer specialist.

Peck sought a second opinion at the Dana Farber Cancer Institute in Boston. Doctors there downgraded his previous diagnosis to pre-cancer, giving him a sense of relief that he "could not put into words."

Still, having been denied service and being unable to afford the out-of-pocket costs of health care, a feeling of helplessness lingered inside.

"I am just a little guy taking on the giant organizations," he thought.

According to the Access Project's report, approximately one in every five adult residents in Massachusetts in 2006 had considerable medical debt.

"There's a silent challenge in resolving issues of exorbitant medical bills, a gap in public awareness," said Andrew Cohen, Access Project's community research coordinator.

"Meanwhile, people are being harassed by collectors, and their credit history being affected," said Jarrett Barrios, president of Blue Cross Blue Shield Foundation.

"People didn't know they could get retroactive coverage for debt through the Health Safety net," said Cohen, referring to the financial program formerly known as uncompensated pool, a joint fund with federal and state resources that covers medical services for the uninsured, low-income patients, and undocumented immigrants.

Under the government-subsidized Health Safety Net, says Cohen, low- and middle-income patients as well as undocumented immigrants may have their bills paid for retroactively, for some medical services rendered as far back as six months previously. Emergency-room visits, for example, are one expense that could get covered under the Health Safety Net.

Undocumented immigrants are not eligible for Commonwealth Care, the state's government-subsidized health-insurance program for low-income residents.

For the one-year period beginning April of 2007, Health Law Advocates, a nonprofit law firm, handled 112 cases of people with significant medical debt. Some patients had outstanding bills ranging from $10,000 to $300,000.

"First, we found that at the providers' level, there's a failure to screen patients appropriately," said Barbara Anthony, the law firm's executive director.

Anthony also said that medical debt should not be treated like expenses accumulated for vacation or shopping bills.

Later, in a phone interview with EthnicNEWz.org -- separate from the conference call with patient Robert Peck and the Access Project -- Cohen explained that undocumented workers, despite their immigration status, can seek his agency's assistance in sorting through hospital debt.

"We don't even ask the question [if they're legally in the country]; it doesn't interest us," he said..

Robert Peck, who had been diagnosed a rare cancer of the blood, was referred to the Access Project by the Men's Health Partnership, a branch of the Massachusetts Department of Public Health, which focuses on reducing health disparities among men.

"With their help, a judge overruled the insurance company's rejection. I didn't have to pay for the care I needed," he said.

Peck, like many others, found he had a chance to appeal his case. The review process took a while, but he highly recommends it.

"Now, I am a lot more productive, and with a healthier attitude," he concludes.

Learn more about the Access Project at accessproject.org.

source: EthnicNEWz.org

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