Attorney General Bonta Announces Results of Investigation into Improper Billing by San Joaquin General Hospital

64 patients in Central California were found to have been wrongfully issued bills for COVID-related care, will be issued refunds or have their bills canceled

OAKLAND — California Attorney General Rob Bonta today announced the successful resolution of an investigation into allegations of improper billing by San Joaquin General Hospital (SJGH) in Central California. The investigation was launched after the California Department of Justice (DOJ) received complaints from the California Rural Legal Assistance Foundation (CRLAF) that patients had been improperly billed for COVID-related care. As a result of the DOJ investigation, 64 patients who were found to have been wrongfully issued bills will now be issued refunds by SJGH or will have their bills canceled. The patients are also being sent letters informing them of the error.

“As someone who is committed to the fight to bring equity to our healthcare system, I take consumer complaints of wrongful medical billing very seriously,” said Attorney General Rob Bonta. “In the midst of a pandemic, these patients were issued burdensome bills for services that were supposed to be completely free. Today, we are taking steps to correct that injustice and bring peace of mind to the 64 wrongfully billed patients and their families. I am grateful to the California Rural Legal Assistance Foundation for bringing their complaints to our attention. My office is committed to working together with our partners across California to protect consumers and ensure access to quality, affordable healthcare for all.”

“The resolution of this investigation affords these 64 families crucial financial relief after they were wrongfully charged for health care services during the COVID-19 pandemic,” said Clarisa Reyes-Becerra, Director of CRLAF’s Immigrant Health Equity Project. “Hospitals and health care providers should be held accountable when they engage in predatory billing practices that take advantage of vulnerable communities, especially those who already face financial, language, and geographic barriers to accessing health care. As an organization dedicated to ensuring quality and affordable access to health care for California's farmworker and rural low-income communities, CRLAF is grateful to the California Attorney General's Office for listening to and investigating the concerns of immigrant farmworkers and achieving a just result.”

Under the federal Families First Coronavirus Response Act (FFCRA), California’s Medicaid program, Medi-Cal, is authorized to provide access to all medically necessary COVID-19 testing and treatment services, including vaccination and hospitalization, at no cost to patients. The program, known in California as the COVID-19 Uninsured Group Program, allows uninsured and underinsured Californians to receive COVID-related care for free. FFCRA applies to COVID-related services rendered from April 8, 2020, and is scheduled to end on May 11.

After being alerted by CRLAF that patients were being billed by SJGH for COVID-related services in violation of FFCRA, DOJ launched an investigation in late 2020 and directed the hospital to conduct a billing audit of its COVID-related care.

In December 2022, SJGH shared the results of its audit, in which staff identified 64 instances where a patient improperly received a bill for a COVID claim. The hospital has agreed to refund or cancel the bills for those patients.

In order to relieve the patients’ anxieties about potential medical debts and help ensure they are not deterred from seeking medical help in the future, DOJ also directed the hospital to issue letters informing the patients about the wrongful billing. A copy of the letter can be found here.

The investigation into SJGH’s billing practices also revealed deficiencies in the hospital’s publication of its policies on financial aid, discount payments, and charity care opportunities required under the Hospital Fair Pricing Policies of the California Health and Safety Code. After being alerted to this problem by DOJ's investigation, SJGH has added notices of patient rights in six additional locations across its facilities.

The California Department of Justice’s Healthcare Rights and Access Section works proactively to increase and protect the affordability, accessibility, and quality of healthcare in California.