Insult To Injury: Arizona Inmates Billed For Prison Health Care
Anew investigation from KJZZ has found that more than a dozen inmates in Arizona prisons are being chased by debt collectors for unpaid medical bills incurred while they were incarcerated. People in state prisons say the medical bills are adding insult to injury. Hear from people who are getting collection notices delivered to their cells and learn about the effects these bills can have on their chances for a successful re-entry to society.
Arizona Inmates Being Chased By Debt Collectors
Ashley Wilkeyson was the captain of the softball team. It was spring of 2017, and she was happy to be outside with her friends on the field. She was had just taken her place at shortstop when she heard the crack of the bat.
“It was a grounder,” she said. “I went down to go get it, tossed it to second and then ...”
She heard another loud crack. A freak misstep had caused her to break her ankle almost completely in half.
“I mean like it was literally hanging off to the side,” Wilkeyson said, now able to laugh about the injury. “It was crazy, right?”
It would take a while for paramedics to get to her, because Wilkeyson and her friends were playing softball inside the Perryville women’s prison, where they lived, in Goodyear. Two years later and one year post-release, Wilkeyson is one of more than a dozen people receiving medical bills for treatment they received while they were incarcerated in Arizona prisons.
Wilkeyson’s injury was so serious health care providers at the prison decided to send Wilkeyson to the hospital. Like other cases examined by KJZZ, Wilkeyson’s bills have come from third-party health care providers. She says the pain was so bad she passed out in the ambulance and woke up at Abrazo West Campus, a nearby hospital that treats Arizona Department of Corrections (ADC) patients.
When she awoke, she was shackled and guarded by two correctional officers.
“My ankle was straight. It was in a splint that goes up to pretty much right below my knee,” she said.
Wilkeyson says the nurses told her they had taken X-rays and reset her leg and scheduled her for surgery.
“And then they sent me back to the prison,” she said.
And that’s when the bills started coming.
“I called my grandma one day and she was like, ‘I just want you to know that we received a bill for almost three grand,’” Wilkeyson said.
Inmates aren’t supposed to pay for their health care in Arizona. They pay $4 to be seen by the health care provider for their first visit, and all services after that are performed, contracted and paid for by the state’s contractor, Corizon Health. The state pays Corizon $15 per inmate per day for a total annual contract worth $188 million.
Wilkeyson says the bill she received was dated from the day her ankle was reset. Corizon medical personnel at the prison instructed her to file a medical grievance and she got a response back saying they would take care of it.
“But then I got another bill the next month. And another bill, the following month,” Wilkeyson said.
First it was medical providers sending the bills, then collection agencies.
“I’m in custody,” Wilkeson thought to herself at the time. “I’m state property. Why are they sending me this bill?”
Wilkeyson has been home for more than a year and the bills are still coming.
Abrazo West representative Keith Jones says the charges are actually coming from physician offices.
“There are independent service providers, like emergency physicians, that have separate agreements with third-party health plans,” Jones said. “Those services are not included as part of a hospital’s billed charges to patients.”
KJZZ was unable to contact Emergency Physicians to comment for the this story.
Jones said after KJZZ contacted Abrazo West asking about Wilkeyson’s charges, the hospital contacted the service providers to ask them to make sure billing and claims are being handled appropriately.
“Patients should expect the independent service providers and third-party payers to assist them to navigate these charges,” Jones said.
The Arizona Department of Corrections and Corizon Health know inmates are getting bills. ADC spokesman Andrew Wilder said it is up to inmates to notify Corizon of the bills.
“ADC is aware that a handful of inmates have received bills from hospitals or other outside specialists who have provided authorized care,” Wilder said. “Inmates should not be billed directly by these outside entities.”
Corizon says when it is notified of inmates receiving bills, the company becomes immediately involved.
“While we cannot control where providers send bills and have no involvement in what collections processes they may choose to pursue, we take very seriously our commitment to pay bills for authorized medical services to the population we serve per our contract terms,” said Corizon Health spokesperson Eve Hutcherson.
“Individuals who have concerns about unpaid bills received personally after release should submit that information to us directly through the contact form on the Corizon website,” Hutcherson said. “Individuals who remain incarcerated and have concerns about unpaid bills for healthcare received can continue to provide them to ADC or Corizon employees and they will be handled and addressed.”
But Ashley Wilkeyson has tried all of those options and the bills are still coming.
“I feel like I’m just banging my head against a brick wall at this point,” Wilkeyson said. “I keep getting the runaround like, ‘Oh, you need to reach out to this person. Oh, you need to reach out to this person.’ I do that, and then I call them, and they’re like, ‘Oh, no, you need to reach out to this person,’ and so I’ve gotten nowhere.”
For all the trouble she’s gone through, Wilkeyson still has pain and bruising on her ankle and doesn’t feel comfortable putting her full weight on it.
“You know trying to get custody of my son, deal with the Corizon stuff, deal with my ankle, I mean, there’s just a lot of stuff.”
“It’s a lot of stress, a lot of things to take on, especially right after getting out,” she said. “I’m just trying to live a normal life and just be a normal person and not make the stupid mistakes I made in the past, ya know?”
Destroying Credit, Successful Re-Entry Chances
Jeffrey LeClair knows when he’s going to have a heart attack.
“I can tell because I can hear the clicking,” he said in an recent interview from the state prison where he lives in Florence. Open-heart surgery left him with noisy metal valves.
“All of a sudden gets extremely rapid and then I start getting short of breath,” he said of a pending heart attack. He has had several in recent years. In one instance in 2017, LeClair says he woke up early in the morning with chest pains.
“All I remember is yelling out as loud as I could ‘I need some help’ and then I don’t remember anything after that,” he said. “I woke up in the hospital.”
He was airlifted to Mountain Vista Medical Center in Mesa, where he says the doctors saved his life.
But then in March 2018, LeClair started getting bills for the treatment in his inmate mail. He still gets them to this day. And now they’re coming from debt collectors.
“It gives you kind of a sinking feeling because you know it’s impossible to pay it.”
LeClair says he’s talked with several other inmates at the Florence prison who are also getting bills. He knew he shouldn’t have to pay, so he filed a grievance with the Arizona Department of Corrections.
LeClair said he believes the state’s prison health care contractor Corizon Health is not paying the third parties it contracts with for specialty care.
He says a hospitalist at Mountain Vista hospital told him at his last visit that Corizon Health’s poor record would impact his access to care.
“I was told that I would not be able to return there for any reason because they’re not paying the bill,” LeClair said.
Prison Law Office attorney Rita Lomio says the buck stops with the state’s contractor.
“Under the contract, Corizon should be paying the bills,” she said. Lomio represents men and women in Arizona prisons in the Parsons versus Ryan health care lawsuit.
“The state pays Corizon almost $200 million to provide health care services like medical imaging, emergency services and specialty care,” Lomio said. “It’s becoming increasingly apparent that in some cases Corizon is pocketing the state’s money and does not pay the doctors and hospitals.”
Lomio says the Prison Law Office first started hearing about inmates getting medical bills while conducting prison tours in early 2018.
“When we were at Perryville, the women’s prison, several women came up to us and showed us bills for hundreds, and I think in at least one or two cases, thousands of dollars. They were for X-rays, CTs and a colonoscopy.”
Lomio says her clients were in disbelief. She says the inmates told them they were not getting assistance with the bills from anyone that worked for ADC or Corizon at the prison.
“There’s no one helping them,” Lomio said. “There’s no one really taking care of this. But the state has a constitutional obligation to provide adequate health care to the men, women and children in its custody.”
Lomio says despite sending multiple letters to Corizon attorneys, the Prison Law Office has had little success getting the bills resolved.
“Unfortunately,” Lomio said, “in some cases even after we do that our clients continue to get collection notices for the same bill or get new notices or new bills for different medical care services.”
Lomio says this would not be the first instance of Corizon being accused of non-payment.
“In Parsons we heard court testimony about hospitals refusing to provide medical services to some people in prison because Corizon had failed to pay its bills,” Lomio said.
Emails disclosed in the Parsons versus Ryan settlement show a representative of the Gilbert Hospital lamenting they had to beg Corizon Health for payment. The emails show Corizon Health owed the hospital more than $1 million for medical services provided to patients in state prisons
Richard Pratt, assistant director of the ADC Health Services Contact Monitoring Bureau, admitted in federal court in the same settlement hearings that he knew Corizon had a history of non-payment problems. Pratt said he “wouldn’t be surprised” if he had told ADC Director Ryan about the non-payment issue from Corizon, but he “couldn’t recall.” Pratt agreed that unpaid bills could “potentially” adversely affect patient care.
Corizon was also recently sued for failing to a pay hospital in Idaho. Lomio is worried the medical unpaid medical bills in Arizona will have devastating consequences for her clients — and their credit ratings.
“People re-entering the community after serving their prison term already face such significant barriers to successful reintegration,” Lomio said. “Undeserved bad credit due to a state contractor’s failure to pay its bills only makes it harder to find housing and gainful employment and to support a family.”
New research on incarcerated people and access to credit shows even a small impact to a person’s credit rating can affect their chances at successful reentry upon release.
Carlos Avenancio-Leon, assistant professor of finance at Indiana University, merged two data sets: court records from Harris County in Texas and data from a major credit bureau.
“So we were able to track, individually, what happened to the credit of individuals that went through the judicial system,” he said.
Avenancio-Leon found when people go to jail or prison, even for a short period of time, their credit rating drops "by about an average of 50 points.”
Avenancio-Leon’s research also found a substantial increase in the risk of recidivism as inmates lose access to credit, something that Joshua Benninger thinks about every day.
Benninger is serving the remaining months of a sentence at the Tucson prison.
“My credit’s pretty important to me,” he said in a recent interview. “I’m a veteran, so I’m trying to take advantage of the VA home loan when I get out.”
But after a bill for a $64 X-ray went to collections without his knowledge, his family noticed a drop in his credit rating of 20 points.
“I don’t see how it could be accidental, ya know?” Benninger said of the billing process. “It makes no sense to me why I would be billed personally. I don’t see how it could just be a procedural error.”
Rita Lomio says the Prison Law Office has collected inmate medical bills totaling more than $50,000. She assumes there are many more, as most inmates are unaware they are not obligated to pay the bills. As Arizona ends its contract with Corizon this summer, Lomio fears more collection notices may be sent to the prisons.
“There’s a real concern that Corizon is going to leave all these unpaid bills in its wake,” Lomio cautioned, “and debt collectors are going to be circling the prisons and our clients and the state is going to be left to try to sort of deal with the fallout.”