According to a recent piece in the Wall Street Journal, several hospital systems in Southern California refused or stalled on taking in COVID-19 patient transfers because of those patient’s insurance status.
This means that patients who were sick and hospital systems that were strained were left waiting or were denied their requests for relief, counter to medical ethics and potentially to federal law.
We take a closer look.
We reached out to Huntington Beach Hospital. They were not able to join us for an interview but sent this statement:
There was no delay in the transfer of patients due to inquiries for further insurance information. The patients were stable and requesting transfer to a medical surgical bed not an ICU bed for higher level of care therefore EMTALA does not apply. EMTALA FAQs state that insurance information can be obtained and is not improper so long as it does not delay a MSE and stabilizing care, and in these patients both the MSE and stabilizing care was already provided at El Centro.
Prime Healthcare has gone above and beyond to collaborate and partner with the needs of the counties and states we serve. Our Paradise Valley Hospital was one of the first to accept patients from El Centro. We have cared for over 10,000 COVID patients throughout this pandemic saving thousands of lives and serving our mission and communities. Just to clarify, there was no request of information regarding insurance that caused any delay in transfer of patients from El Centro. We were ready to care for these patients and made calls to the transfer center. The fact that the transfers did not occur was likely related to the fact that the accepting hospital was already near capacity and did not have ICU capacity which may have been needed should the patients’ condition deteriorate and require ICU care, therefore perhaps the decision to transfer to a different facility was based on the best interests of the patient and ability to ensure greater capacitance at the accepting hospital.
We reached out to Cedars-Sinai. They were not able to join us for an interview but sent this statement:
The surge of hospitalized COVID-19 patients in Imperial County erupted with little notice, and Cedars-Sinai responded to the urgent need. On May 25, Cedars-Sinai accepted five patients. We were the only hospital in Los Angeles County accepting transfer patients from Imperial County at this time. One day later, on May 26, we received a request to accept three additional transfers from Imperial County. We declined primarily because we were concerned about our own ability to maintain adequate capacity to handle an anticipated COVID-19 surge in Los Angeles County. Additionally, those three patients did not require the higher level of care provided by Cedars-Sinai and other academic medical centers.
It wasn't until May 27 that the state instituted its All Access Transfer Center and began distributing Imperial County COVID-19 patients to hospitals across the state. Once this occurred, we accepted eight additional patients. From May 25 to June 25, we accepted 13 transfer patients from Imperial County. For all of the transfer patients we treated, we accepted whatever their insurance would pay. We did not bill any of these patients for remaining balances.
We have played a key role as a provider treating COVID-19 patients. Since March 1, we've cared for more than 1,000 hospitalized COVID-19 patients.
We reached out to Loma Linda University Health. They were not able to join us for an interview but sent this statement:
Most hospitals have a standard practice that if emergency Medi-Cal doesn’t cover an uninsured patient, the transferring hospital is charged up to 130% Medicare rates, not the patient. This is common practice amongst hospitals and has been the process well before the COVID-19 pandemic hit.
On May 28, 2020, we were informed by CHA that Imperial County was on internal disaster, at which time we began taking their patients regardless of their insurance or the hospital’s ability to pay.