Hey there, Temperature readers, we’re bringing you an extra-packed edition of the newsletter this week to spotlight a major new investigative piece we published Monday about the debt collection practices of Colorado’s largest hospital system, UCHealth.
The investigation is the product of a multi-newsroom collaboration between The Colorado Sun, 9News and KFF Health News, brought together by the Colorado News Collaborative. It’s also the first of several pieces that newsrooms working with COLab will report over the coming weeks on the issue of medical debt and its consequences. The project picks up locally from KFF Health News’ nationwide investigation called Diagnosis: Debt.
These stories will be available for news outlets across the state to publish free of charge, and they highlight the commitment we have at The Colorado Sun to produce quality journalism that leads to a more-informed Colorado. That’s pretty cool, right?
If you’d like to help us keep doing the work we do, donate now to support in-dept, impactful reporting. As always, we appreciate your support.
Now let’s dive in.
TEMP CHECK
HEALTH
How we found out that UCHealth sues thousands of people a year — but keeps its names off the lawsuits
When we knocked on Lorena Sanchez’s door, she was prepared.
Shortly after photographer Olivia Sun and I sat down in her living room, Sanchez pulled out a hefty manila folder stuffed with hospital bills and legal records. What spilled out of that folder provided fresh insight into the stress, confusion, frustration and fear of being sued by UCHealth.
The nonprofit hospital system, which brings in more than $6 billion a year from treating patients and last year recorded $839 million in total profits, including more than $330 million in operating profits, sues thousands of patients per year. But, for the last four years, almost none of those lawsuits have been in UCHealth’s name.
When we began trying to track medical debt lawsuits in Colorado, our colleagues at 9News, Chris Vanderveen and Anna Hewson, built a database of cases with UCHealth’s name on them. A chart from that database looked like this:
UCHealth did pause debt collection activities for about six months at the start of the COVID-19 pandemic. But, when it started again, something had changed. And that brings us back to Lorena Sanchez’s manila folder.
Sanchez was involved in a car crash near Colorado Springs in early 2021. But when she was sued in 2023 over the ER bill from that accident, the complaint looked like this:
Nothing in the public lawsuit complaint reveals what the debt is from or how the debt collector, Credit Service Company, came to be the one suing over it. Believe me, we read every document.
The only place where this is revealed to be a lawsuit over debt owed to UCHealth is in an exhibit in the case file that is sealed from public view. It looks like this:
This system is super-confusing for patients.
“I couldn’t figure out what this bill was,” one patient told Vanderveen.
“This looks like a scam,” another one said.
The system also makes it impossible for anyone in the public — you, me, state regulators, lawmakers — to track UCHealth’s litigiousness. When we began reporting this story late last year, consumer groups told us they estimated the number of UCHealth debt lawsuits filed over the past five years to be around 11,000.
But we kept reporting. Vanderveen called dozens of people who were being sued by Credit Service Company, one of two debt collection vendors UCHealth uses, to find people willing to talk with us. One morning, we went to court in Adams County to watch as people responded to legal summonses for all manner of debt cases, including medical debt cases.
When we sat down for an interview with an executive from UCHealth, she said the hospital system wanted to be transparent. They had nothing to hide, she said. Which is how we learned two, never-before-revealed stats:
All told, reporting this story took months, involving dozens of interviews and hours upon hours of reading through court records.
And there’s still so much we don’t know. For instance, Sanchez was originally sued for more than $24,000, which was four times what she actually owed. How many other patients are like her, taken to court over money they don’t owe? And how many other hospitals in Colorado are using this same system?
You can read our entire story on the UCHealth lawsuits here.
And if you have a story of your own, you’d like to share, hit me up at johningold@coloradosun.com.
LEGISLATURE
Will lawmakers make hospitals use their own names when they sue?
Last year, Democrats in the state legislature introduced a bill that would have required medical providers to put their own names on lawsuits against patients when they are the owners of the debt.
The bill, which made other sweeping changes to medical debt practices in Colorado, passed. The provision requiring medical providers to sue under their own names did not.
Instead, that requirement was stripped out during the bill’s first committee hearing. Attorneys who represent debt collectors testified that making hospitals and other providers sue under their own names would violate patient privacy by revealing that patients received medical treatment and where.
The concern focused not so much on large hospital systems like UCHealth but on specialty providers like addiction treatment centers, where the name of the provider might give an indication of the type of treatment. “To embarrass the patient a lot in order to embarrass the provider a little,” is how Alan Greenberg, the president of the Colorado Creditor Bar Association, put it during the hearing.
(It is worth noting that national reporting by KFF Health News has found that hospitals across the country commonly use their own names when they sue, which is also what UCHealth used to do.)
The debt collection attorneys also made arguments similar to UCHealth’s — that once the debt is legally “assigned” to a collection agency, it becomes the agency’s to control, making them the rightful plaintiff even if they don’t own the debt. But it was the patient privacy element that most caught lawmakers’ attention, earning the amendment bipartisan support.
“I’m trying to strike a balance between giving the patient enough information to know that they are satisfying debt that is truly theirs without airing all their laundry,” said Sen. Jim Smallwood, a Parker Republican who proposed the amendment.
The bill’s sponsors, though, were against the change to their bill.
“We will not be able to know what is happening with our bill,” said one of the sponsors, Sen. Sonya Jaquez Lewis, a Boulder County Democrat. “We will not be able to track the extent of medical debt because we won’t be able to see the whole picture.”
But the bill’s sponsors do not expect to bring the issue back up this session.
Another sponsor, Sen. Lisa Cutter, a Jefferson County Democrat, said in an interview this week that she still believes hospitals should have to use their own names in lawsuits against patients. But she said she and other supporters of the idea are waiting for the resolution of a lawsuit that challenges the legality of the practice.
“We possibly will pursue legislative remedies after that either to codify a good decision and make sure it sticks or make a change and make sure it doesn’t happen that way again,” she said.
The lawsuit, filed by the group Towards Justice on behalf of two plaintiffs sued by a debt collector working for UCHealth, has been awaiting a judge’s ruling on motions for summary judgment for nearly a year.
MORE HEALTH NEWS
CLIMATE
Gas lawn mowers heading for the graveyard?
A partial ban on the use of gas lawn mowers to cut the Front Range’s intractable ozone problem is now official.
The Air Quality Control Commission approved a staff proposal to bar use of gas-powered mowers and leaf blowers in summer months on government-owned properties, like parks or building grounds. Some environmental advocates and metro officials wanted the AQCC to go a step further and ban the sale of gas-powered equipment to cut into ozone-causing pollutants, but the AQCC had rejected that tougher stance.
The ban on use by public entities goes into effect in 2025.
Despite the softened approach, environmental groups are calling a win.
It’s a “good first step,” CoPIRG’s Kirsten Schatz said. Gas lawn equipment supplies a small but measurable part of the pollutants that cook up into the Front Range ozone problem, which puts EPA restrictions on a nine-county area until Colorado comes into compliance. Clean air advocates have called the bans some of the only low-hanging fruit left in the ozone fight, in part because reliable battery-powered equipment is increasingly available from the biggest names in the lawn industry. Advocates say the electric equipment also becomes price-competitive with gas models when buyers take advantage of government rebates.
“It doesn’t make sense to allow tons of pollution that damages our health just from cutting grass and blowing leaves around when cleaner, quieter electric options are readily available,” Schatz said.
CLIMATE
Atmos gas won’t have to pay its customers to use less … gas. For now.
Atmos Energy will not have to set up a system to compensate its gas customers for using far less gas, after the Public Utilities Commission said last week it wasn’t ready to, in essence, force gas-only utilities to plan for their own demise.
Environmental groups wanted the PUC to make gas-only utilities like Atmos start planning for customer rebates when they switch from gas-burning appliances like furnaces or water heaters to cleaner electric versions. Atmos, a Texas-based for profit that serves 127,000 Colorado customers with gas only, argued it shouldn’t have to pay customers incentives to disconnect from its product or use far less of it.
An administrative law judge had approved the Atmos “demand-side management plan” to the state without any provision for starting clean electric rebates, as Xcel and other utilities have done. Xcel is different in that when customers use less natural gas for heating or cooking, they are switching to clean electricity that Xcel is also supplying them.
Environmental groups Earthjustice and Southwest Energy Efficiency Project had appealed that judge’s decision, saying the Colorado targets for greenhouse gas reductions in coming years will require gas-only utilities to contribute to emissions cuts, and clean electric rebates will be a key to that.
The PUC denied the appeal, Earthjustice attorney Michael Hiatt said. “But they also clarified and explained that beneficial electrification may well be warranted and necessary in gas only utilities’ Clean Heat Plans or Gas Infrastructure Plans” in the future, Hiatt said.
“So it was a loss for us, but the upside is that Atmos and other gas-only utilities will likely not be able to simply ignore beneficial electrification in the future.”
MORE CLIMATE NEWS
CHART OF THE WEEK
As Colorado prepares for a big ramp-up in packaging recycling in coming years, people are still surprised that glass is one of the few materials where the state has a full-cycle industrial program to melt down returned glass and re-use it. We could do much better with glass locally, and glass is one big target of the “producer responsibility fee” that will raise money on consumer packaging and give it to communities to create more curbside recycling pickup.
This chart shows the opportunity. Glass should be easy, right? It’s relatively clean and once melted down, can be remade an infinite number of times into safe, consumer-ready new packaging. But instead, we’re still throwing most of it into landfills or burning it in industrial-scale garbage incinerators that convert waste to steam-driven electricity. So, let’s say that glass is half-full.
HEAT MAP
CLIMATE
HEALTH
Thanks for reading this week — and every week, for that matter. We literally couldn’t do this without you.
Till next week.
— John & Michael
Corrections & Clarifications
Colorado Sun contributor Sue McMillin’s name was misspelled in the Feb. 14, 2024, edition of The Temperature.
Notice something wrong? The Colorado Sun has an ethical responsibility to fix all factual errors. Request a correction by emailing corrections@coloradosun.com.