AG Ferguson: Providence must provide $157.8 million in refunds and debt relief for unlawful medical charges to low-income Washingtonians

Attorney General Bob Ferguson announced today that Providence, one of the nation’s largest healthcare systems, must forgive more than $137 million in medical debt and refund more than $20 million to patients the company billed for services despite knowing they likely qualified for free or reduced-cost health care. 

The $157.8 million resolution will provide full refunds, plus interest, and debt forgiveness for 99,446 individuals. It is the largest resolution of its kind in the country.

State law requires hospitals to provide medical financial assistance, also known as charity care, to Washingtonians based on their income level — for both insured and uninsured patients. Hospitals are required to notify patients about this protection and check to see whether they are eligible for discounts on their out-of-pocket expenses.

Ferguson filed an enforcement action against Providence for deceiving patients into believing they had no choice but to pay their medical bill, and unlawfully shifting the burden onto patients to self-identify their eligibility for financial assistance. This created barriers to affordable care for thousands of the most vulnerable Washingtonians.

The legally enforceable agreement, filed today in King County Superior Court, resolves Ferguson’s lawsuit against all hospitals operated by Providence and its Washington affiliates, Swedish Medical Center and Kadlec Regional Medical Center.

Ferguson’s lawsuit asserted that between 2018 and 2023, Providence routinely disregarded its legal obligations. 

Instead, Providence trained staff to aggressively ask for payment from patients who were likely eligible for financial assistance, or simply billed them without determining if they qualified. 

In thousands of cases, Providence knowingly sent low-income patients — including Medicaid enrollees — to debt collectors. One of Providence’s own employees warned leadership that the health system’s practices were “sending the poor to bad debt.”

Providence health system operates hospitals across Washington. Many of its hospitals are either the largest or the only hospital in the area. Swedish First Hill and Providence Sacred Heart are among the largest hospitals in the state, with more than 600 beds. 

Together, these hospitals reported more than $18 billion in patient service revenues in 2020.

“Washingtonians concerned about the rising cost of health care should know that my team is fighting to enforce critical protections that improve affordability,” Ferguson said.

If patients have questions about whether they qualify for this resolution, they should contact Providence. The Attorney General’s Office does not have patient data. Providence can be reached at 855-229-6466.

The case against Providence is part of Ferguson’s Health Care Initiative. The resolution is the largest of four charity care cases handled by his office, resulting in more than $205 million in debt forgiveness and refunds for Washingtonians

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