Cancer patient from Meredith ordered by judge to pay bill

LACONIA — A Meredith woman in a battle with breast and brain cancer is now facing the costly reality of not having medical insurance.

A Superior Court judge has ordered her and her husband, sued by Lakes Region General Hospital for non-payment of medical bills, to make payment secured by an attachment on their home.

In March, the hospital filed suit against Paul Hough and his wife, Wanda, of 19 Water St., Meredith for $48,081.26 in medical bills, plus accruing interest and legal fees connected to the collection efforts.

Judge Larry Smukler granted the hospital's motion for summary judgment on the basis of statements and evidence presented for the record without a trial. Such action is used when there is no dispute to the facts of the case, and one party is entitled to judgment as a matter of law.

On Tuesday, the court also ordered the Houghs to pay $1,742 in attorney fees. Earlier this month, the court granted the hospital a $55,000 attachment against the Hough's modest Cape-style home in Meredith.

Mrs. Hough, 55, received treatment for breast cancer at the hospital between Aug. 2, 2004 and June 28, 2004 and underwent a single mastectomy. She has since been diagnosed with brain cancer.

She claims that just five days after having a brain tumor removed at Dartmouth-Hitchcock Medical Center she was getting phone calls from the hospital asking for money for her prior surgery.

"I'm sure there are a lot of other people in the community thinking 'this could be me,'" said Maureen Criasia, a friend of the Houghs who worked as a registered nurse for 30 years.

As health insurance costs continue to increase, Criasia predicts more people will be unable to afford health insurance and will be saddled with huge medical bills if they get sick.

"We owe the money and we know we owe the money," said Paul Hough, maintaining the collection tactics employed by the hospital have placed additional stress on his wife while she is battling a life-threatening illness.

The couple didn't have insurance when the diagnosis was made. They'd dropped their coverage and used the added cash to help bolster the operation of their antique and used furniture shop.

In its lawsuit, the hospital, through its attorney, Margaret Sullivan of Laconia, charges that the Houghs failed to pay the costs of the medical care even though Mrs. Hough had signed a standard agreement on admission authorizing the hospital to begin collection proceedings if the bills weren't paid.

The writ claims the Houghs were "unjustly enriched" by the services the hospital provided.

On March 1, 2005, Lisa Delaney a patient accounts supervisor at the hospital signed a petition to attach with notice asking the court to order a $60,000 attachment against the Houghs real estate.

The petition claimed that the hospital believed it would recover a judgment in the amount of $60,000 and that unless the attachment was allowed there was a reasonable likelihood that the defendant's assets would be insufficient to satisfy a judgment.

Smukler granted the attachment but limited it to $55,000 and also ordered it "subordinate to all existing liens and attachments."

In a handwritten motion objecting to the attachment request, Hough said that the couple were in the process of applying for Medicaid and were currently making monthly debtor payments as part of a Chapter 13 bankruptcy plan accepted by the U.S. Bankruptcy Court in Manchester.

Court records indicate the Houghs paid $450 on the original $48,081.67 total hospital bill. The hospital is charging 4 percent interest daily and is also asking to recoup $145 in filing fees paid to the court, $44 paid to the sheriff's department for serving the writ of summons, $1,742 in legal fees, $1.34 in postage and $20.75 in photo copying fees.

Paul Hough says he tried to make weekly payments to the hospital but was told the nearly $50,000 bill would need to be paid in its entirety. The hospital offered to have them take out a mortgage on their home, but Hough rejected it as he thought the payments were unaffordable.

According to court records, the Houghs filed for bankruptcy on March 16, 2004. The bankruptcy court approved a repayment plan in which the couple began making monthly payments of $180 for 50 months in June 2004. Outside the repayment plan the Houghs are also paying their monthly mortgage plus making payments on their 1999 Ford van.

In a motion filed with the court on April 29, Mr. Hough said the couple had retained the services of an attorney with New Hampshire Legal Assistance, who had taken their Medicaid case and is confident that he can get the denial reversed and the medical bills due the hospital paid retroactive to 90 days to last April's filing date.

The couple has signed an agreement with state that explains state law mandates reimbursement from "my or my spouse's estate," to the state and county as a condition of eligibility for Medicaid. Under the terms of such an agreement, Hough said he and his wife could maintain lifetime residency of the home. The debt would be repaid upon their deaths when the property was sold.

Meanwhile, Hough says both Concord Hospital and Dartmouth-Hitchcock Medical Center have both provided medical treatment to his wife and have agreed to cover her expenses until they find out during a June 8 appeals hearing whether she will receive Medicaid.

Hough maintains LRGH fast-tracked collection efforts to avoid having to accept a Medicaid settlement that would pay less.

On May 3, the hospital filed a motion seeking summary judgment of post-bankruptcy petition debt claiming that the Houghs failed to amend their bankruptcy filing to add the hospital as an unsecured general creditor.

The Houghs objected. "The objection is based on a bankruptcy filing which occurred before the billed services were rendered. It is not based on the merits of the claim. As the record indicates the (hospital) is entitled to judgment as a matter of law on the undisputed facts. The motion is granted," Smukler wrote in his order granting the summary judgment.

Christopher Boothby, director of development and community affairs for LRGHeathcare (which owns LRGH and Franklin Regional Hospital) has characterized such suits as infrequent.

But a review of records in Belknap County Superior Court shows the hospital filed 165 such suits last year and has two attorneys working to collect on unpaid medical bills.

This year, 28 such cases had return dates in May, 20 in April and four in March.

While Boothby said he could not comment specifically on the Hough case, he said, the number of lawsuit filed by the hospital considering the number of patients it serves remains small.

"I would re-enforce that it's a situation of last resort. No one, not the patient, not the hospital wants to have a matter go to court. We work very hard to provide options to people," he said.

Boothby cited the Patient Advantage program that he said has attracted interest from other hospitals nationwide.

Boothby explained that the program was the brainchild of CEO Tom Clairmont, and was sparked after the administrator watched the "average guy charged more than the big HMO and realized there had to be a way to level the playing field."

If patients pay their bills at or near the time of service they can receive up to a 20 percent discount. More importantly, Boothby said, each time a patient is discharged hospital staff has the chance to meet with them, learn about their needs and has the opportunity to offer counseling or refer them to HealthLink or other programs that can help meet their needs.

But on the other side of the equation, Boothby maintains its unfair to individuals who meet their financial obligations to allow people who do have legitimate needs walk away without paying at least a portion of their bills.

"It's a delicate balance, one we've put a tremendous amount of time and energy into. To be fair to everyone in the community it sometimes become necessary to go to that last resort," Boothby concluded.

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LRGH sucks. I avoid taking my kids there and prefer Concord. However, I had to use the emergency room once when my son broke his arm two years ago and had to wait over two hours for the "on call" bone Doc to come in.

Maybe they simply couldn't afford to keep it.

No, they could afford it. They dropped the coverage to redirect that money elsewhere.

"It's up to us to call the doctor's offices and hospitals on these unnecessary tests and charges.

Easy to say when one knows they are unnecessary. A little harder call to make when it comes to tumors, eh?"

Yes, you are speaking about the unknown, and I am using a scenario of known facts.

Another scenario: Let's say I go in for arthroscopic surgery knowing that I will be given a knee brace and crutches, why don't I decline those, thereby reducing the medical burden to my health insurer, and use the knee brace and crutches that are already in my closet, given to me from the initial injury?

If we are going to be diligent in participating in our health maintenance plan, being directly involved in the decrease of health costs/expenses should be our responsibility also.

I bet half the people on this thread have no clue as to what medical insurance for a 50 something husband and wife costs...

That is irrelevant to this couple and their situation. They did not drop their insurance because it was too expensive and they couldn't afford it. They dropped their insurance to spend the money elsewhere.

I wonder how fast medical costs would have risen had we not had some 10 million Illegals leeching off the system.

Yes, the Houghs gambled and lost. But they are attempting to pay it as best they can.

What bothers me is this:
"A Superior Court judge has ordered her and her husband, sued by Lakes Region General Hospital for non-payment of medical bills, to make payment secured by an attachment on their home."

If this was not part of the original agreement/contract signed by both parties, it should not be added now.

The object of health insurance is not to cover the common cold or hangnail, but to cover catastrophic health problems. Unfortunately, much of the general public doesn't think in this mindset.

Health insurance is NOT for catastrophic health. It is for hospitalization, doctor visits and prescriptions. They now sell catastrophic health coverage separately. Ain't that wonderful!!

Health insurance used to be called hospitalization and it ONLY covered hospitalizations and the Dr if he visited you in the hospital. If you had major medical it would cover some portion of your office calls IF you first met the deductible. Dr. offices did not used to be packed with whining...patients. And doctors did not have the huge malpractice premiums. So who can you blame for high health costs??

Any party who has won a suit against someone for owed financial compensation can place a lien on that persons home for the money owed. It doesn't have to be part of a contract or agreement earlier entered into. The attachment is often referred to as a Mechanics Lien.

What's this story's point? ... Where's the thread going?

I suspect the point of the story was to scare people into accepting single-payer insurance IOWs nationalized healthcare.

"The object of health insurance is not to cover the common cold or hangnail, but to cover catastrophic health problems. ....Health insurance is NOT for catastrophic health. It is for hospitalization, doctor visits and prescriptions. They now sell catastrophic health coverage separately... ."

Hmmmm, I'll rethink. But having been a licensed insurance agent, it has always been my opinion that medical insurance was for catastrophic health problems. I'll admit to having been out of the insurance industry for 10 years.

A person should have to pay their debts but I agree with states like Florida which make your home exempt from judgements.

I don't know what the limits are but basically your homestead cannot be reached through judgements.

Yes, I practice Neurology here and see predominantly patients with epilepsy. I do see people without insurance. The fees my office charges are set by the government (based on procedure code) but for self pay patients I've made arrangements for a percentage of that. Most testing is performed through the hospital and they charge their own fees and can be negotiated with as well.

If we are going to be diligent in participating in our health maintenance plan, being directly involved in the decrease of health costs/expenses should be our responsibility also.

You aren't getting an argument from me on personal responsibility. However, I also think we need to limit the litigation business enjoyed by so many. You aren't an attorney are you ;-)

Sure, liens are placed on property as a result from judgments.
I think a Mechanic's lien would be a different animal.

Point is they were making the arranged payments. This wasn't fast enough for this hospital. Looks like this particular facility is impatient quite often.

"...... Superior Court shows the hospital filed 165 such suits last year...."

Yes, I agree that the practice of unnecessary malpractice lawsuits is damaging our health care industry. I've seen doctors go out of business because of it. I personally had to have a c-section (major surgery) rather than natural birth because the OBGYN was afraid of lawsuits.

C-section is major surgery requiring two, three or more days in the hospital. Natural birth, and you might leave the hospital the next day.

Hmmm . . . I have PLMD and RLS, so I do see a neurologist whose name I bet you'd know.

$130 office visits are just insane, even if insurance DOES cover the rest of it. Nothing happens to me in my 30 minutes in that office that costs the doctor more than $10, and that's all labor, and way jacked-up if you consider the sum total of the labor involved is to whack my knee with that little rubber axe..

Solution: Become a Mexican Citizen and come here illegally, you are covered.

Exactly!! That's the only way to make it these days. Jobs, Medicaid, food stamps, free legal, dental and eye coverage, etc. makes it very tempting doesn't it? LOL It's no wonder we're having an invasion.

I have a teacher neighbor who recently (December) had a brain tumor and was in very bad shape after surgery. She was transferred to a rehab center approximately late-Jan and when her insurance ran out she was discharged. The rehab center did not feel she was ready to be discharged. She cannot walk yet. I believe her insurance is through the State and is a very good insurance.

And catastrophic insurance is a separate premium--even at the State. I am not sure the State even offers a group plan?

The Dr and the hospital make more money on C-sections not to mention the convenience. I think litigation is a scapegoat for this.

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