Becerra questions Providence on Catholic health rules
California Atty. General Xavier Becerra revealed on Tuesday that his office was investigating whether Catholic healthcare chain Providence Health violated legal obligations by enforcing religious restrictions on care at one of Orange County’s major hospitals.
Becerra’s office is requesting a bunch of documents from Providence about his dealings with Hoag Memorial Hospital, a Newport Beach medical center with which he has worked since 2016 and is now in an acrimonious dispute.
It comes as Becerra awaits confirmation by the Senate of her appointment as President Biden’s Health and Human Services secretary.
Becerra’s action follows a confidential complaint several Hoag doctors filed with his office in October.
The doctors, all specialists in women’s health, detailed numerous examples in which they said Providence applied ethical and religious guidelines for Catholic health care in Hoag.
Providence has established a history of broken trust in its relationship with us, with no end in sight.
Complaint from doctors Hoag to the Attorney General
Applying ethical and religious guidelines to most treatments at Hoag would be in direct violation conditions that Becerra’s predecessor as attorney general, Kamala Harris, imposed when it approved an affiliation between Hoag and the Catholic St. Joseph Health system in 2014. Hoag was founded as a Presbyterian institution in 1952.
Harris had jurisdiction over the affiliation because both parties were California nonprofit institutions. When St. Joseph merged with Providence Health & Services in 2016, creating the fourth largest Catholic hospital chain in the country, Harris demanded that the merged company accept all conditions 2014.
At that time, Providence declared that all the conditions would be “scrupulously observed”.
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According to the doctors’ complaint, Providence’s physician management arm, Heritage Healthcare, has consistently refused to pay for contraceptive services for HMO patients in Hoag. Providence has also delayed permissions to treat miscarriages or other women’s health services, they said.
In at least one case, they said, Heritage specifically cited ethical and religious guidelines in refusing to pay for a patient’s intrauterine device insertion.
“Providence has established a history of broken trust in its relationship with us, with no end in sight,” said the complaint, which is not a public document but one that I have reviewed.
Harris mandated, among other things, that St. Joseph and Providence would maintain service levels for women before the merger in Hoag until at least 2033. Its approval also specified that Hoag would then not be subject to ethical and religious guidelines or the future. ”
There was only one exception: Harris allowed Hoag to be subject to a ban on “direct abortions” – a Catholic term with no medical definition. Harris was elected U.S. vice president in November.
Becerra revealed her investigation in a letter sent on Tuesday to the directors of Hoag, St. Joseph, Providence and Covenant Health (the official designation of the affiliation between Hoag and Providence).
The letter says Becerra’s office “monitors” whether ethical and religious guidelines “are or have been applied to any aspect of a service, procedure or other activity … performed by obstetricians / gynecologists. Hoag. ” The letter includes a broad request for documents related to the issues, with a deadline of March 23.
The letter also states that the Attorney General “is monitoring whether any administrative obstacles are or have been placed on OB / GYN Hoag’s efforts to obtain reimbursement for services, procedures or other reproductive activities of women subject to restrictions from the ERD.” .
This appears to be a direct reference to the doctors’ complaint that “Providence has increasingly prohibited health services for women when they involve any form of contraceptive care”, even when IUDs are prescribed for reasons. other than birth control, such as a heavy period. bleeding.
“We have seen IUD reimbursements, for example, pending for as long as two years, requiring multiple appeals and grievances on behalf of patients,” the complaint states. “In many cases, payment is never received.”
Providence told me by e-mail that it “welcomes the request for further information from the Attorney General and that it is confident that the examination will show that Providence has always complied with all the requirements under the conditions of fusion”.
Hoag’s growing dissatisfaction with his affiliation with Providence Health came to light in May, when his management sued Providence to dissolve the arrangement.
The lawsuit cites Providence’s increasingly strict religion-based limits on medical treatment in Hoag. He also says that Providence, which is based in Renton, Wash., Failed to meet the affiliate’s original goal of improving decision-making and local politics at its Orange County hospitals.
Providence is fighting the dissolution in court, arguing that Hoag has no right to dissolve the arrangement unilaterally. But he also quietly negotiated Hoag’s exit, possibly on a financial payment from Hoag.
The bad blood between the affiliate partners has intensified since the lawsuit. As I reported last month, Providence has removed Hoag doctors and emergency care facilities from its provider network, forcing thousands of patients to find new specialists and seek urgent treatment elsewhere.
Providence has also removed Hoag from the list of its Southern California websites.
Hoag’s suppliers argue that the measures are retaliation for the dissolution case, which Providence denies, attributing its actions to the choice of Hoag’s doctors not to participate in its network.