Lawyers agree deal to collect hospital debt

| 30/01/2018 | 43 Comments

(CNS): The Health Services Authority has appointed the local law firm HSM Chambers to collect cash from patients that have not paid their hospital bills. HSA officials said the firm won an open tender process last year and it has since entered into an agreement on how the debt, which has plagued the hospital for many years, will be collected. Under the terms of the deal the HSA will transfer outstanding patient debts to the law firm after “all other efforts have been exhausted by the Authority”, who will then pursue the patients for cash, many whom were under- or uninsured.

In a press release about the agreement, officials said that HSM will undertake an initial pilot project based on a representative sample from the broad range of outstanding amounts. These will be transferred from the HSA to the lawyers for collection, which could see those who owe money being dragged through the courts. The authority said patients with outstanding balances now have a grace period to make payments directly to the hospital before further accounts are turned over to the law firm for debt collection.

As part of any legal proceedings initiated by HSM, the names and amounts due will be made public, the authority stated.

At a Public Accounts Committee hearing last year, Lizzette Yearwood, the CEO of the Health Services Authority, revealed the plan to contract out the debt collection to lawyers. She said at the time that the details of how the collection would work were still being negotiated.

This week she said this deal with HSM was a last resort to recover the more than $70 million which is still owed to the Authority by patients who, she said, “have reneged on their commitments, despite repeated attempts by the HSA to secure payment”.

Yearwood said the substantial amount owed by patients, if collected, could make a significant
difference to the hospital’s financial position and enhance the healthcare services provided for all residents in the Cayman Islands.

“If this money was collected and reinvested in the HSA it could make a substantial difference, enabling the hiring of more doctors and nurses, acquiring additional equipment and technology, expansion of needed clinical space to ensure continuity of safe, high quality healthcare services that are accessible to all,” she added.

Yearwood said the hospital would continue to fulfill its mandate as the national healthcare system for the Cayman Islands by ensuring that no one is denied emergency medical care at its facilities, but it must ensure financial sustainability by collecting revenue it earns for services provided. The HSA will still provide support to patients who are uninsured or under-insured via available government programmes, other support mechanisms and facilitating pre-payment plans for elective medical services.

Huw Moses, the managing partner of the law firm which will now be going after the bad debtors, many of whom are likely to be among the poorer members of the community, said the firm would exercise all due diligence in its pursuit of debt collection. It will operate under procedures and protocols agreed with the authority, including strict requirements on the initiation of legal proceedings for outstanding payments, which can only be undertaken after all other efforts have been exhausted.

He urged patients who are contacted by his firm to immediately engage in a constructive dialogue with the lawyers, as ignoring correspondence or failing to contact HSM after a request for payment was made could also result in the matter being brought before the courts. Moses said the hospital had a critical role as the national healthcare provider and the facility of first resort by those with medical needs. But he said its financial sustainability was important to ensure continuity of healthcare services for all people.

“This can only be done if everyone pays for their medical care, which allows the HSA to have the resources to purchase medical supplies, recruit high-caliber clinical staff and invest in technology and facilities to meet the healthcare needs of our community,” the lawyer stated.

The HSA has not revealed the full details of the contract — if the lawyers will receive a percentage fee from what they collect or a flat fee rather, as was suggested at the PAC hearing last year. CNS has contacted hospital officials with questions and is awaiting a response.

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Category: Government Finance, Health, Politics, Prison

Comments (43)

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  1. Shhhhhhhhhh. says:

    Pity they will not be collecting from Watson and his cronies.




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  2. Anonymous says:

    Does anybody pay their bills anymore? People expect all kinds of services form Government but don’t want to pay for the services.




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  3. Anonymous says:

    the more money saved…the more politicians waste….💆




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  4. Anonymous says:

    A lot of the poor record keeping and controls at HSA may in fact hide the fact that there are many debts that have been paid in full in CASH. Sounds to me like a recipe for internal fraud so who’s to say that some of the balances owed found their way into the wrong pockets.

    It’s happened before. We keep hearing about employees taking fees and not recording them so I can’t help but wonder if something might be going on at HSA too.




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  5. Gray Matter says:

    Solutions I have:
    *1 Give DART the Dump property and he pays the $ 70,000,000.00

    *2 Population on Cayman approx 52,000 persons…. Debt is $ 70,000,000.00
    Remove the amounts racked up by. Inmates, drug heads, bar room brawls and stabbings, drunks who meet in accidents, teen pregnancy, I would say about $ 35,000,000.00 LET THE LAWYERS DEAL WITH.

    True Balance: $ 35,000,000.00

    Elected Government and opposition about (25) .. Give $ 2,000.00 per month towards true balance = $ 600,000.00 per annum.

    Working population “Cayman Kind” of approx 45,000 chips in $ 63.70 per month towards true balance = $ 34,398,000.00 per annum.

    In one year 50% of debt repaid.




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    • Anonymous says:

      Why should people who didn’t incur debts pay for you to cover yours? Inept and possibly corrupt systems/people are to blame here, collect it off them…




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  6. Anonymous says:

    It is good that the debt collection issue at HSA is pursued, but what will be done simultaneously to fix the obvious broken system. Be it bad accounting, be it people who have no means to pay health insurance/hospital bills etc. Unless those issues are addressed, HSA will be back in the same position in no time……….you know, like the aggressive Iguana culling program and then……..nothing………..




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    • Anonymous says:

      You forget to mention the patients that have received services, have an open account, have received a statement, CAN AFFORD TO PAY, and who are trying to get away without paying. If you’re one of those patients, shame on you. Go to GTH and pay off your debt.




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  7. Lo-Cal says:

    What I don’t understand is how the hospital collect their payment minus the agreed deductible of which they call the insurance company to verify, then still turn around and send you a bill for a difference?

    Do they not have an agreed rate of payment for service from the insurance?
    If they do, are they charging more than the agreed rate and billing the patient the difference?
    Is this just a difference in the currency conversion? Some insurance use US instead of KYD




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    • Anonymous says:

      I 100% agree with your comment. You agree on an amount, the insurance company agrees what they will cover and you pay the difference. Then inevitably you get a bill a few months later for some portion that the insurance company didn’t cover or the hospital added as additional charges.

      The issue is that 6 months have no elapsed and I can no longer deal with the insurance company on how to manage the claim.

      This conflict between what is acceptable to charge and what the insurance company will cover needs to be CLEAR. If you want to charge more then the insurance company will cover then bill me up front…don’t come knocking at my door 6 months to a year later.




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      • Anonymous says:

        Not just the HSA do this, but some private practitioners too…you walk out thinking you have paid your deductible and insurance pays their’s, then you get billed some more…I always refuse to pay any extra…if they can’t get it right, its their problem. Its not as if they only do it once in a while, they do it many times, every day. No excuses.




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    • Anonymous says:

      The problem is that the insurance company must be sent the invoice within six months of them agreeing to pay. After six months they won’t pay. This happened to me and HSA came after me for the now unpaid insurance payment. I absolutely refuse to pay something that was caused by their incompetence….




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    • Anonymous says:

      Happened to me! Paid all bills and then 10 months later they send me another erroneous bill that the insurance didn’t cover. I argued that they did indeed cover it. However, I no longer worked for the same company and no way was the insurance going to discuss a 10 month old bill!!




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    • Anonymous says:

      It’s impossible for healthcare facilities to know in advance EXACTLY which aspects of the care given is not covered by the patient’s policy. When the insurance company doesn’t pay the full amount, the balance becomes the responsibility of the patient..




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  8. Anonymous says:

    None of this would be happening if we had a state run system where we all pay a percentage of our salaries to the government, instead of the ridiculous insurance premiums we pay now.




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    • Really? says:

      The state can’t run 2 car-park pay machines at the airport, what makes you think they can run a health system for all?




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  9. Anonymous says:

    CNS – you should ask HSA how much of that $70m is past the statute of limitation?

    HSA sent me a bill (after I paid the amount requested at the hospital that night) with just an amount, no narrative, no description – nothing. I wrote back and advised them that if they want paying they have to tell me what it is I’m paying for, obviously! One year later, no response. If my name ends up on that list through their incompetence HSM can expect a counter-suit.




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  10. Anonymous says:

    Genuine question – is there a law in Cayman that allows Government to seize someone’s assets if residents don’t pay their debt?




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  11. Anonymous says:

    Mostly poor people, uninsured or under insured.
    Is that the fault of these people? Or is there something wrong with the healthcare system ?
    It is absolutely disgusting how our Western, Americanized society of so called christians, has become.




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    • Anonymous says:

      My heart goes out to all the poor people. Now they have to go to jail to get healthcare. Meanwhile the reach steal millions from the same healthcare system and are allowed to keep the ill gotten gains




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    • Anonymous says:

      Sounds like you need to pay up.




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    • Anonymous says:

      I don’t totally agree that these outstanding debts belong to just poor or uninsured people. I am sure that if the list of outstanding debtors is ever published such list will include a lot of people who are known to have money or who do not fall in the categories of poor and uninsured! There are a lot of people in Cayman (politicians included, as I have witnessed myself) that prioritize their debts differently! You have certain people in charge of the Governments purse that can’t even deal with their own financial affairs – let alone be in charge of a country?!!!

      A couple of years ago I had to have a procedure done at Chrissie Tomlinson. When I went in the week before to have my blood work done I was told that I had a $40 bill outstanding from a few years ago. To be honest, I don’t think that was correct, but I was also told that if I didn’t pay such I would not be having my procedure done. So I paid the money even though I didn’t agree with it. Why aren’t these people with outstanding debt told the same thing? “Sorry we can not serve you, you have an outstanding bill?”

      There are so many people that abuse the services of the hospital. I have worked with people that would go sit in the ER for 8 hours to be seen because they have a cold! Hence why the HSA is in such a bad state! It needs to be run like a business not a charity!




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  12. Gray Matter says:

    How smart; going after poor people to go before the Judge and tell him/her … Your horror we don’t have it. Then the law firm sends a big bill to the HSA … And gets paid … Now the Government is further in debt. Smart move Yearwood.




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  13. Anonymous says:

    the Contract is FOIable. CNS can we see a copy?

    CNS: We do a fair amount of FOIs but they can be really time consuming. So if you’d like to do this, we’d be happy to publish the result.




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  14. Anonymous says:

    I continually receive a bill that has already been paid. I provided the hospital with a copy of the debit card transaction, but they continue to send the bill and not reply to my emails. The HSA accounting system is a part of the problem.




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  15. Anonymous says:

    We might need to build a debtors’ prison as I suspect that most of the people that have outstanding bills at the HSA don’t have the ability to pay those debts. Many of the individuals I suspect have serious health issues that have most likely limited their ability to work as they did prior to their illness or injury. This whole thing speaks to the need for a move towards a national health service and away from the current private health insurance system that is not fit for purpose and is not meeting the needs of many of our residents.




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  16. Tur Alors! says:

    The public are entitled to a lot more transparency from the HSA. How was this “open tender” process managed, was it advertised and what are the arrangements for passing on recovered funds to the HSA?. Given the large sums involved this could be a goldmine for the law firm. What are the protocols agreed with the HSA, if a debtor has no job and due to health reasons no likelihood of getting one will the law firm pursue any assets they may have and leave them penniless. This will only cause severe social problems and leave the debtor reliant on Goverment to subsist.




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  17. Anon says:

    Who is collecting from no use Canova Watson??????????

    CNS Note: He will be in court again Thursday see story here




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  18. Anonymous says:

    I hope they get their records straight before antagonising ppl for debt they don’t owe.




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  19. Anonymous says:

    I do hope they come to collect my “debt” that has already been paid by the insurance company. Bring it!




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    • Anonymous says:

      Calm down. Why would they?




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    • Anonymous says:

      Agreed. I think some of the data the HSA holds on outstanding debt is at best questionable. Where would that leave HSM if they published a name saying they owed money and they didn’t, would they be held liable for slander? I’m not stupid enough to think there isn’t some genuine cash owed the HSA, but I do know they’ve got my accounts wrong before.




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      • Anonymous says:

        I have personallly made three trips to the financial office and numerous phone calls to try to sort out a bill I received from them for a mammogram I had using a free voucher to get the procedure done. I have heard many stories similar to mine. They have never been good at accounting and record keeping. It will be interesting to know how they get on with HSM and how much they will have to pay them for actually getting these cases to court. HSA will probably have to pay out more than they actually collect due to poor records.




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