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An US non-profit hospital, Mosaic forgave bills and stopped suing poor people, when came to light

Mosaic used to refuse medical attention to those that they had sued. Now, under their new policy which came about in 2015, the patients enter into a medical debt grace period

Heartland Regional Medical Center, a nonprofit, is the only hospital in St. Joseph, Mo. The hospital and its system of clinics recently rebranded as Mosaic. Image source:
  • Heartland Regional Medical Center sued low income patients for their medical bills
  • The hospital pardoned the debt in light of a new financial assistance policy
  • Many patients were unaware the policy even existed

Poor People were sued for inability to pay bills by an US non-profit hospital. When came to light, forgave bills

An US non-profit hospital, Mosaic forgave bills and stopped suing poor people, when came to light

Heartland Regional Medical Center nonprofit hospital in St. Joseph, Missouri in United States. sued low income patients because they were not paying hospital bills. In light of these findings, Senator Charles Grassley stated, “Let me be clear: Nonprofit hospitals should not be in the business of aggressively suing their patients. In essence, because of the favorable tax treatment these hospitals receive, they have a duty to help our nation’s most vulnerable.”

Senator Charles Grassley. Image source: Wikimedia Commons.
Senator Charles Grassley. Image source: Wikimedia Commons.

A republican from Iowa, he made it clear that it was unacceptable that this issue had to be brought to the attention of not only congress but the press. He said that it should not have come to this, and the hospital should have upheld its mission and helped those in need.

It was due to an investigation done by NPR and ProPublica that led to uncovering the lawsuits Heartland Regional Medical Center, now known as Mosaic Life Care, was issuing. In fact, to NPR and ProPublica’s surprise, Mosaic was not the only nonprofit hospital that was quietly suing patients.

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Mosaic and other nonprofit hospitals such as, Deaconess Hospital in Evansville, Indiana, have started to revisit their financial assistance policies. Mosaic used to refuse medical attention to those that they had sued. Now, under their new policy which came about in 2015, the patients enter into a medical debt grace period. With this policy, even the patients who owe the hospital money can receive medical attention.

Heartland Regional Medical Center. Image source:
Heartland Regional Medical Center. Image source:

This new policy relieved 3,342 people of their debt. The total amounted to $17 million being pardoned. That is a substantial amount of money that the money will never receive. Interestingly enough, they are still trying to obtain some sort of payment from patients who owe them. Keith Herie, a patient, said that he still owed the hospital over $26,000. After looking at his income, Mosaic deemed his income too high to allow his debts to be pardoned. The patient settled on paying $8,300 to Mosaic. That was after the fact that he had already paid $20,000 to the hospital prior to the official changes in Mosaic’s policy.

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In another interesting discovery ProPublica reached out to Keith Berry, a man who is on disability. He had not heard that Mosaic had a new debt forgiveness policy. When he contacted the hospital, they simply stated that he was too old and did not qualify. The policy does have specific steps. The debt period is held from October 1, thru December 31. During these days, patients, who having outstanding debt, must apply to be considered eligible to receive the benefits of this policy.

The CEO of the hospital said that although the hospital has done everything medically right for their patients, they are learning to do the same when it comes to finances. It is not just Mosaic and Deaconess that have failed the patients financially. Under half of 1,800 hospitals studied had failed to notify patients of their financial assistance policy prior to billing them.

Abigail Andrea is an intern at NewsGram. Twitter @abby_kono


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Iowa and Nevada to Cast their Votes over Telephone

Democrats in the early presidential contest states of Iowa and Nevada will be able to cast their votes

FILE - An audience member arrives at a rally for a 2020 Democratic presidential candidate at the University of Iowa in Iowa City, Iowa, March 8, 2019. VOA

Democrats in the early presidential contest states of Iowa and Nevada will be able to cast their votes over the telephone instead of showing up at their states’ traditional neighborhood caucus meetings next February, according to plans unveiled by the state parties.

The tele-caucus systems, the result of a mandate from the Democratic National Committee, are aimed at opening the local-level political gatherings to more people, especially evening shift-workers and people with disabilities, whom critics of the caucuses have long said are blocked from the process.

The changes are expected to boost voter participation across the board, presenting a new opportunity for the Democratic Party’s 2020 candidates to drive up support in the crucial early voting states.

“This is a no-excuse option” for participation, said Shelby Wiltz, the Nevada Democrats’ caucus director.

Iowa, Nevada, Votes
FILE – A precinct captain argues his position during a Democratic caucus at the University of Nevada in Reno, Nevada, Feb. 20, 2016. VOA

Party officials don’t have an estimate of how many voters will take advantage of the call-in option. But in Iowa, some recent polls show as many as 20% of Democrats will participate virtually. In Nevada, most voters tend to cast ballots early during regular elections, and party officials expect many will take advantage of the early presidential vote.

While rolling out a new voting system holds the promise of more voter participation, it also comes with potential risk for confusion or technical troubles. But the party is moving forward to try and address long-standing criticism that the caucuses are exclusionary and favor some candidates over others.

Increasing criticism

The Iowa caucuses, a series of party-run, local-level organizing meetings that adopted a presidential preference element more than 50 years ago, have come under increasing criticism in the past decade for their fixed evening time and place. Such rules effectively barred participation in the first-in-the-country nominating contest, for instance, for parents unable to find child care or older voters hesitant to venture out in the dead of winter.

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Hillary Clinton and her supporters complained that Iowa’s process “disenfranchised” those unable to attend after she finished a disappointing third place in the 2008 caucuses.

In 2016, backers of Sen. Bernie Sanders cried foul over the Iowa results when Clinton won a razor-thin margin, 49.9% to 49.6%, despite some irregularities in reporting results. The dispute, replicated in part in Nevada, was a key factor in the push from groups on the left to overhaul the nominating process heading into 2020.

Nevada, the third state in the Democrats’ nominating contest sequence, has only been an early caucus state since 2008, and the process still remains relatively new to many residents.

Rural benefits

Iowa, Nevada, Votes
FILE – Precinct Chairwoman Judy Wittkop explains the rules during a caucus in Le Mars, Iowa, Jan. 3, 2008. VOA

By opting for a dial-in program, the systems can reach people in Iowa’s and Nevada’s vast rural stretches where broadband internet coverage may be spotty. Iowa since 2014 has offered a smaller-scale tele-caucus, allowing out-of-state members of the military and Iowans living abroad to call in to live neighborhood caucus meetings and participate over the phone.

“One, we are a rural state. And let’s be honest, outside of Las Vegas and Reno, Nevada is a rural state. Everyone is connected by phone,” Iowa Democratic Party Chairman Troy Price said.

The DNC’s mandate has been a challenge for party operatives who sought to maintain security while also maintaining the spirit of the caucuses, which are chiefly local, party-building activities aimed at electing delegates to party conventions. Officials say by avoiding an internet-based program, they are reducing the risk of hacking, a key concern in an era of renewed concern about election tampering.

While Nevada Democrats said accessibility, not security, drove them to opt for a phone-in system, Iowa Democrats said they felt a lower-tech option was safer.

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“With this system, it’s easier than making sure thousands of computers across the state are not filled with malware and not being hacked,” Price said.

Security concerns

Yet officials acknowledge that relying on phone systems does raise security concerns.

“Are they unhackable? Certainly not,” said Jeremy Epstein, a voting systems expert with ACM, the largest international association of computer science professionals. “None of these technologies are really bullet proof.”

The state parties presented their plans late last month to the DNC’s Rules and Bylaws Committee. Committee members applauded the work and gave conditional approval but asked for more information about the security and functionality of the systems.

“We are working with every state party that is integrating these tools so they can make their voting process secure and successful. We look forward to working with Democrats in these states to address the committee’s questions,” DNC spokesman David Bergstein said in a statement.

Both state parties plan to require Democratic voters to register online in advance of their virtual caucus, verifying their identity with a “multi-factor authentication.” Voters will receive a PIN that they’ll have to enter when they call in to participate.

Iowans who register on time will have six times to choose from to participate by phone, including the in-person caucus night, Feb. 3. Nevadans who register for the virtual caucus can participate on Feb. 16 or 17. Unlike Iowa, Nevada is also offering four days of in-person early caucusing to give people more options.

Wiltz said security experts with the DNC will be vetting the systems later this year to test for vulnerabilities to breaches or hacking.

“This isn’t something that we’re taking lightly. We understand our responsibility,” Wiltz said. (VOA)