HCA agrees to refunds for Mission Health patients
Nashville-based HCA Healthcare has agreed to drop fees it added for visits to Mission Health’s cancer and surgery centers, and primary-care and other specialty clinics, and will issue refunds to patients who paid them.
HCA bought Asheville, N.C.based Mission, formerly a not-forprofit system, in February 2019 and implemented a billing change five months later.
Greg Lowe, president of HCA’s North Carolina division, said Mission had previously billed commercial insurers and Medicare differently for visits to “provider-based departments,” which are outpatient clinics that are considered part of a hospital. The change, he wrote, was designed to correct the difference.
When billing commercial insurers, Mission had classified visits to its outpatient clinics as free-standing physician offices, meaning there was no hospital facility fee attached. Under the billing change, more than 20 outpatient clinics became classified as hospital outpatient departments in bills to commercial insurers, meaning the insurers were charged facility fees.
As it turned out, patients became responsible for those fees in the form of copayments or coinsurance.
In a March 18 letter to patients, Mission said it will refund or write off the accounts of patients whose out-ofpocket payments changed on
Aug. 1, 2019. Specifically, the system said it won’t seek payment for outstanding coinsurance or copayment amounts for patients covered under commercial insurance or Medicare Advantage plans who visited those facilities from Aug. 1, 2019 to March 17. For patients who already paid, Mission said it will issue refunds by May 31.