How New York Hospitals Charge the Most

to Those Least Able to Pay

Hospital Bill
__________________________________
You owe $55,243.00 for
appendectomy*
*But HMOs only pay $2,500.00
Wall Street Journal 3/17/03

March 2006

Public Policy and Education Fund of New York

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 The Great Hospital Heist:
How New York Hospitals Charge the Most
to those Least Able to Pay

Introduction
This report draws on data from the New York State Department of Health to calculate the
amount that hospitals in New York overcharge uninsured patients and other patients who are
unable to pay their full hospital bills. “Overcharges,” as used in this report, are the amounts that
the hospital charges greater than the reasonable cost of providing care, according to the
hospitals’ own reporting to the New York State Health Department.

Hospitals in New York and around the country establish a charge rate, comparable to a
list price, for hospital services. However, very few of a hospital’s patients ever pay the charge
rate. As a spokesperson for the American Hospital Association explained on the CBS news show
60 Minutes on Sunday March 5th, 2006, “Actually, what hospitals charge for a service is the
same for everybody, whether they have insurance or not. What’s confusing for everybody is that
what a person ends up paying in this country can be very different.”

Medicaid, Medicare, and most private insurance plans actually pay rates that are
significant discounts off the charge rate. Insurance companies negotiate the discount with
hospitals. Medicare pays hospitals at rates established under federal law and Medicaid pays rates
established under New York State law.

The only patients who are expected to pay the charge rate are uninsured patients and the
few patients who are covered by insurance plans that have not negotiated a hospital discount.
These patients are generally known as “self-pay” patients.

Hospitals in New York are required to report the total amounts they charge for inpatient
and outpatient care to the New York State Department of Health (DOH). Hospitals are also
required to report the reasonable cost of providing care for purposes of calculating Medicaid
rates. Using this information, DOH calculates a conversion factor for each hospital, which is the
ratio of cost to charges.

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 Hospitals in New York receive $847 million annually from the State to compensate them
for bills that have not been paid by patients. These funds are generally referred to as ‘bad-debt
and charity care’ funds or BD&CC. Inpatient and outpatient BD&CC charges are accounted for
separately. In order to calculate how much each hospital is due from the BD&CC fund, hospitals
report to the Department of Health the total amount of hospital charges for which the hospital did
not receive payment. Bad debt is defined as amounts that are considered “uncollectible”. If an
amount previously written off is later collected, it is reduced from bad-debt in future reports.
Charity care, which is called “free care” in the DOH data, is the reduction in charges made
because “the patient is indigent or medically indigent.” (Note: “Courtesy” discounts to
physicians, employees, hospital board members, etc. cannot be charged to BD&CC.)1

The Department of Health applies the individual hospital conversion ratio to that
hospital’s total BD&CC charges to calculate the actual cost to that hospital for providing
BD&CC. A complicated formula is then used to distribute the $847 million – the formula and
amount are set by legislation – from the BD&CC pool fund to the individual hospitals; the fund
does not cover the full cost of BD&CC for most hospitals.

This report uses the DOH data on BD&CC charges and costs to calculate the aggregate
amount that hospitals charge in excess of the actual cost of providing care to patients who are
uninsured or can’t afford to pay their bills. We call these amounts, ‘overcharges.’

Findings
The Public Policy and Education fund of New York (PPEF) analyzed the data reported by
210 hospitals throughout to the New York State Department of Health for 2003, the most recent
year for which data were available. Based on these data, there are a number of findings about
overcharges to self-pay patients in New York.

INPATIENT OVERCHARGE RATE

! On average, New York State hospitals charge self-pay patients 2.3 times more than the
cost of providing inpatient care. The cost of providing care is only 43% of the amount
charged for inpatient care.
! The inpatient overcharge rate varies dramatically among hospitals.
o Parkway Hospital, one of only two for-profit general hospitals reporting to the
Department of Health, had the highest overcharge rate for inpatient care, charging
patients 7.3 times the cost of providing care.
o 9 hospitals charged more than 4 times the cost of providing inpatient care.

1
NYCRR Title 10, Section 86-1.11(g)(1)(i)(a &b)

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 o 31 hospitals charged more than 3 times the cost of providing inpatient care.
o 101 hospitals charged 2 or more times the cost of providing inpatient care.
o On the other extreme, there were actually 4 hospitals that charge less than the cost of
providing care and an additional 5 hospitals that have charges that closely match,
within 10%, the cost of providing inpatient care.
! There are big regional differences in overcharge rates – See Table 1.
o Suburban hospitals have the highest overcharge rates, with hospitals on Long Island
charging 2.7 times the cost of inpatient care and hospitals in Westchester County
charging 2.5 times the cost of inpatient care.
o Hospitals in New York City and in the Northeast region (north of the NYC suburbs)
had an overcharge rate of 2.3 times the cost of inpatient care.
o Upstate hospitals located west of the Hudson River generally did not inflate their
charges as much as hospitals downstate. Hospitals in Rochester had the lowest
overcharge rate, 1.6 times the cost of providing inpatient care.

Table 1: Inpatient Overcharge Rates by Region

Region Inpatient Overcharge Rate

Long Island 2.7 (Charges are 2.7 times higher than costs.)
Northern Metropolitan 2.5
New York City 2.3
Northeast 2.3
Western 2.1
Utica/Watertown 1.8
Central 1.7
Rochester 1.6
Statewide 2.3

! There are substantial differences in overcharge rates by types of hospitals, using a DOH
classification2 – see Table 2.
o Hospitals that overcharge at the highest rate – 2.6 times the cost of inpatient care –
are non-profit hospitals that do not care for a disproportionate number of low-income

2
There are 5 types of hospitals:
• Voluntary SLIPA (Supplementary Low Income Patient Adjustment) are non-profit hospitals that see a
disproportionate number of Medicaid and low-income uninsured patients.
• Voluntary non-SLIPA hospitals are non-profit hospitals that see more low-income patients.
• Distressed hospitals are considered to be in very bad financial condition, often because of the large number
of low-income patients they serve.
• Rural hospitals are a group of hospitals in rural areas.
• Major public hospitals are public entities controlled by the New York City Health and Hospitals
Corporation and state and county run hospitals.

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 (Medicaid or self-pay) patients. These are called Voluntary non-SLIPA
(Supplementary Low Income Patient Adjustment) hospitals.
o Public hospitals inflate their charges the least, charging on average 1.5 times the cost
of inpatient care.
o Rural hospitals also do not inflate their charges as much as others, charging on
average 1.7 times the cost of inpatient care.

Table 2: Inpatient Overcharge Rates by Hospital Type

Hospital Type Inpatient Overcharge Rate

Voluntary non-SLIPA 2.6
Voluntary SLIPA (serve more low-income patients) 2.4
Distressed (hospital in poor financial condition) 2.3
Rural 1.7
Major Public 1.5
Statewide 2.3

OUTPATIENT OVERCHARGE RATE

! On average, New York hospitals charge self-pay patients 1.6 times more than the cost of
providing outpatient care. The cost of providing care is only 61% of the amount charged
for outpatient care.
! The outpatient overcharge rate varies dramatically among hospitals.
o 4 hospitals, including Parkway Hospital, one of only two for-profit general hospitals
in New York, charged 4 times the cost of providing outpatient care.
o 15 hospitals charged more than 3 times the cost of providing outpatient care.
o 66 hospitals charged more than 2 times the cost of providing outpatient care.
o 141 hospitals charged 1.5 or more times the cost of providing outpatient care.
o On the other extreme, 13 hospitals charged less (2% to 28%) than the cost of
providing care and an additional 6 hospitals’ charges closely matched, within 10%,
the cost of providing outpatient care.
! There are big regional differences in overcharge rates – See Table 3.
o Hospitals in the Northeast region of the State have the highest overcharge rates for
outpatient care, 2.4 times.
o Hospitals in New York City had the lowest over charge rate, largely – as data below
show – due to the large number of public hospitals.

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 Table 3: Outpatient Overcharge Rates by Region

Region Outpatient Overcharge Rate

Northeast 2.4 (Charges are 2.4 times higher than costs.)
Northern Metropolitan 2.1
Long Island 2.0
Utica/Watertown 1.9
Western 1.8
Central 1.7
Rochester 1.6
New York City 1.4
Statewide 1.6

! There are also substantial differences in overcharge rates by types of hospitals, using
the DOH classification – see Table 4.
o Voluntary non-SLIPA and rural hospitals overcharge the most, followed by voluntary
SLIPA and distressed hospitals.
o Public hospitals only charge slightly more than the cost of actually providing care,
with their costs at 94% of the charge rate.

Table 4: Outpatient Overcharge Rates by Hospital Type

Hospital Type Outpatient Overcharge Rate

Voluntary non SLIPA 1.9
Rural 1.8
Voluntary SLIPA (serve more low-income patients) 1.5
Distressed (hospital in poor financial condition) 1.5
Major Public 1.1
Statewide 1.6

AMOUNT OF OVERCHARGES

The 210 hospitals in New York State collectively overcharged self-pay patients by $1.1
billion in 2003. That is the patients who were self-pay – patients who are uninsured or did not
have an insurance plan that has negotiated a discount with the hospital – were charged $1.1
billion more than the reasonable cost to the hospital of providing services.
! Of those aggregate overcharges:

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 o $648 million were inpatient overcharges;
o $462 million were outpatient overcharges.
! Two large New York City based academic medical centers had the highest total overcharges.
o St. Lukes Roosevelt - $48 million
o New York Presbyterian - $48 million.
! Three other New York City hospitals had overcharges of $30 million or more:
o Montefiore - $37 million;
o Jamaica Hospital - $33 million;
o Beth Israel – $33 million.
! Each of 17 hospitals had overcharges of $20 million or more.
! Each of 29 hospitals had overcharges of $10 million or more.
! Each of 137 hospitals had overcharges of $1 million or more.

THE BIGGEST BURGLARS

Fourteen hospitals ranked in the top 50 for both their overcharge rate and the total
amount of overcharges. The list includes several of New York’s largest teaching hospitals that
have relatively high overcharge rates and a large number of beds: St. Luke’s Roosevelt, Beth
Israel; Staten Island University, Maimonides and Lenox Hill. The list also includes three smaller,

Biggest Burglars:
Hospitals Among Top 50 in Inpatient Overcharge Rate and Total Overcharges
Inpatient
Overcharge Total
Hospital Overcharges
Rate

PARKWAY HOSPITAL 7.3 $12,059,371

BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER INC 5.2 $24,105,461
LENOX HILL HOSPITAL 5.0 $24,366,359
INTERFAITH MEDICAL CENTER 3.8 $15,198,661
CABRINI MEDICAL CENTER 3.5 $ 8,454,907
ST LUKES-CORNWALL HOSPITAL 3.3 $ 9,017,702
MONTEFIORE HOSPITAL & MEDICAL CENTER 3.2 $37,116,153
GOOD SAMARITAN HOSPITAL OF SUFFERN 3.1 $ 9,604,435
MAIMONIDES MEDICAL CENTER 3.0 $29,647,343
STATEN ISLAND UNIVERSITY HOSPITAL 2.9 $15,313,519
FRANKLIN GENERAL HOSPITAL 2.9 $ 8,555,429
ORANGE REGIONAL MEDICAL CENTER 2.9 $ 8,147,403
BETH ISRAEL MEDICAL CENTER 2.8 $32,772,531
ST LUKES - ROOSEVELT HOSPITAL CENTER 2.8 $48,440,398

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 non-teaching hospitals that earn their dubious distinction because of their high overcharge rates:
Brookhaven; St. Luke’s Cornwall and Orange Medical Center. As mentioned previously,
Parkway tops the list because of its outrageously high overcharge rate which leads to very high
total overcharges even though the hospital is only moderately sized. The other hospitals on the
list are moderately large teaching hospitals with relatively high overcharge rates: Interfaith;
Montefiore; Cabrini; Franklin General; and Good Samaritan.

Discussion
More than 5.6 million New Yorkers, one-out-of three people under the age of 65, did not
have health coverage for all or part of 2002-2003, according to a June 2004 report released by
Families USA. Most of these New Yorkers, 65%, went without health insurance for six months
or longer. According to a report from the National Institutes of Health, 18,000 Americans die
prematurely each year due to the lack of health insurance.
High medical bills have severe impact on individual and family finances. Medical debt is
the second most frequent cause of personal bankruptcies. Hospital billing practices exacerbate
any financial crisis facing New Yorkers. As this report demonstrates, hospitals in New York
State charge uninsured patients more than twice the hospitals’ cost of providing health care.
Low and moderate-income uninsured patients usually do not get discounts similar to the rates
paid by Medicaid, Medicare, or private insurance companies. In New York State, these
overcharges statewide amount to about $1 billion annually.

Some hospitals also engage in aggressive debt collection activities, routinely sending
uninsured patients vastly inflated bills, using collection agencies to hound patients for payments,
and taking steps such as garnishing wages or attaching bank accounts to secure payment. It is
these hospital billing and collection practices that are largely responsible for the fact that medical
costs are the second leading cause of personal bankruptcy.
Until recently, hospital associations nationally and in New York long maintained that
Medicare required them to bill the uninsured at the “full-charge” rate and try to collect the debt.
On February 19, 2004, then U.S. Secretary of Health and Human Services Tommy G. Thompson
sent a letter to the president of the American Hospital Association disagreeing with the hospital
associations’ interpretation of Medicare regulations by writing: “Nothing in the Medicare
program rules or regulations prohibit such discounts [for low-income patients].”
In response to negative publicity and a Congressional investigation into hospital billing
and collection practices, the American Hospital Association (AHA) issued voluntary guidelines
to its member hospitals in December 2003. The Healthcare Association of New York State

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 (HANYS), the statewide hospital association, approved its own set of guidelines Financial
Aid/Charity Care Policy at New York’s Not-for-Profit Hospitals in January 2004.

While the hospital associations’ guidelines are an acknowledgement of the need for
hospitals to do better, they are no substitute for legislation. Both the AHA and HANYS
guidelines themselves are weak, providing little in actual patient protections. In addition, since
they are voluntary – lacking the force of law or an enforcement mechanism – they do not
establish accountability for the use of public dollars.
Hospitals individually and collectively often tout the amount of “charity care” they
provide. The Preamble to the HANYS guidelines claims that New York hospitals provide
“almost $2 billion a year in uncompensated care.”3 It fails to explain if the dollar calculation is
based on the full charge rate or the lower, actual cost of care. There is no mention of federal and
state governments’ provision of significant amounts of taxpayers’ dollars to hospitals every year
to offset some of these costs. The federal government provides $22 billion a year to hospitals
nationwide and New York State provides $847 million a year to cover the costs of bad debt and
charity care.
The hospitals also fail to mention the dollar value of the significant exemptions they
receive for property, school, and sales taxes. These exemptions are taxpayer funding for
hospitals to provide community benefits. Under New York State and Federal laws, hospitals
may and do include a wide array of activities under the headings “uncompensated care,” “charity
care,” and/or “community benefits.” The various activities do, in fact, benefit the community but
most hospitals fail to state clearly that care for those unable to pay is only a portion of the total
dollar amount they report to the public. At least one hospital was more forthcoming; it reported
that “care for the poor” in 2003 accounted for about a third, $8 million, of its “nearly $25 million
in community benefits.” The other two-thirds, $17 million, covered “under-reimbursement by
Medicare and Medicaid, free lectures and health screenings in the community, and the value of
volunteer labor.”4

The Nassau County Department of Health reports that total charges for charity care
provided by the 12 hospitals in the county in 2003 were $68.5 million dollars. In contrast, the
reported cost of that care was actually one-third lower, $45.3 million.5 There was significant
variation from hospital to hospital in the ratio of charges to cost: one hospital reported charges

3
Ibid.
4
St. Peter’s Hospital. 2004. “Celebrating 135 Years of Caring.” Supplement to the Times Union. Albany, New
York. November 1, 2004. p.21.
5
Nassau County Department of Health. 2004. Fiscal Year 2003 Nassau County Hospital Charity Care Report. Nassau
County, NY. October 2004. Table 2.
http://www.nassaucountyny.gov/official/resources/file/eb00094f5cd4681/CharityCareFY2003Report_10-25-04.pdf

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 almost 3 times more than its cost and another reported charges only 8% higher than its costs.
Even hospitals in the same health system reported very different cost to charge ratios.

Long before the voluntary guidelines or HHS letter, some states had enacted laws and
regulations that require hospitals to provide discounts to patients based on financial need. Two
of New York’s neighbors, Massachusetts and New Jersey, require hospitals to comply with
statewide eligibility criteria, screening and application process, reporting requirements, and a
payment mechanism for charity care. But New York State, which provides hospitals with $847
million a year to compensate hospitals for unpaid bills, has no such requirements.

In both March 2005 and March 2006, the NYS Assembly passed three bills by wide bi-
partisan votes (only 10 or 11 negative votes out of 150 Assembly members) – on legislative
proposals that would establish statewide standards for providing financial assistance to patients.
The package of three bills introduced by the chairs of the Assembly Insurance and Health
Committees, Alexander “Pete” Grannis (D-Manhattan) and Richard Gottfried (D- Manhattan)
would: (1) set statewide eligibility standards; (2) establish a statewide discounted rate for those
with incomes under 200% of the federal poverty level and require sliding scale discounts for
patients under 400% of poverty; (3) standardize the application process; (4) define covered
services; (5) forbid egregious billing and debt collection practices; (6) specify public disclosure
on how taxpayers’ funds were used; (7) require notices to the public about available financial
aid; (8) instruct hospitals to bill low to moderate-income uninsured patients at the discounted rate
paid by Medicare or other insurers; and (9) create an independent appeals process.

The Governor’s 2005 HCRA proposal included some new procedural requirements for
hospitals to qualify for funds from the BD&CC fund pools, procedures. The Governor included
similar proposals in his 2006-2007 budget. His Health Commissioner, Antonia Novello, also
pledged to advocate enactment of financial assistance protections after news stories reported the
death of a young man who was denied treatment due to the lack of health coverage. The NYS
Senate included the Governor’s proposal in its March 2006 budget resolution.

The Public Policy and Education Fund conducted surveys of 19 hospitals in four upstate
cities in 2005 - 2006 to see whether the hospitals are meeting the standards set forth in the
legislation passed by the Assembly. With regard to the specific issue addressed in this study,
whether hospitals provide discounts to self-pay patients, our surveys found seven hospitals
(37%) that meet the standards set forth in the Assembly legislation: providing free care (other
than small co-payments) to patients who earn up to 200% of the federal poverty level and sliding

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 fee payments based on income to patients who earn up to 400% of the federal poverty level.6 The
surveys also found an additional three hospitals that met the first part of the standard (full
discount up to 200% of poverty) and two hospitals that met the second part of the standard (a
sliding scale discount to 400% of poverty.)7
The findings of these surveys demonstrate that the standards are reasonable, since more
than half –12 of 19 – of the hospitals voluntarily are in compliance with at least one of the two
standards. The PPEF surveys also demonstrate that voluntary guidelines do not work, since only
37% are in full compliance.

The data presented in this report demonstrate that hospitals routinely charge uninsured
New Yorkers more than twice the cost of providing care. These findings underscore the urgency
for the Governor and State Senate to join the Assembly to enact strong consumer financial
assistance protections for uninsured New Yorkers and other New York hospital patients who are
unable to pay their hospital bills.
.

6
A family of four earns $39,900 at 200% of the FPL and $79,800 at 400% of FPL. An individual earns $20,100 at
200% of FPL and $40,200 at 400% of FPL.
7
The cities were Rochester; Utica; Syracuse and Buffalo. The hospitals that were in full compliance were Faxton-
St.Luke’s in Utica; St. Joseph’s in Syracuse; and five hospitals run by Kaleida in Buffalo. In addition: Highland in
Rochester, Community General in Syracuse and St. Elizabeth’s in Utica provided a full discount up to 200% of FPL;
Parkridge in Rochester and Crouse in Syracuse provided a sliding discount up to 400% of FPL.

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 Appendix: Hospitals’ Inpatient Overcharge Rate
and Total Amount of Overcharges
Inpatient
Overcharge
Hospital Rate Total Overcharges
ADIRONDACK MEDICAL CENTER 1.7 $ 439,243
ALBANY MEDICAL CENTER HOSPITAL 2.2 $ 7,308,966
ALBANY MEDICAL CENTER HOSPITAL - SOUTH CAMPUS 1.8 $ 121,568
ALBERT LINDLEY LEE MEMORIAL HOSPITAL 1.7 $ 273,870
ALICE HYDE MEMORIAL HOSPITAL 1.7 $ 496,089
AMSTERDAM MEMORIAL HOSPITAL 1.7 $ 144,288
ARNOT-OGDEN MEMORIAL HOSPITAL 2.0 $ 2,008,717
AUBURN MEMORIAL HOSPITAL 2.0 $ 951,912
AURELIA OSBORN FOX MEMORIAL HOSPITAL 1.7 $ 935,564
BASSETT HOSPITAL OF SCHOHARIE 1.4 $ 157,623
BELLEVUE HOSPITAL CENTER 1.5 $ 16,840,005
BELLEVUE MATERNITY HOSPITAL INC 1.8 $ 219,174
BENEDICTINE HOSPITAL 2.9 $ 2,596,302
BERTRAND CHAFFEE HOSPITAL 1.3 $ 75,248
BETH ISRAEL HOSPITAL - KINGS HIGHWAY DIVISION 4.5 $ 2,637,666
BETH ISRAEL MEDICAL CENTER 2.8 $ 32,772,531
BLYTHEDALE CHILDRENS HOSPITAL 2.1 $ 865,736
BON SECOURS HOSPITAL 3.1 $ 4,988,501
BRONX-LEBANON HOSPITAL CENTER-FULTON DIVISION 2.7 $ 29,128,188
BROOKDALE HOSPITAL MEDICAL CENTER 1.9 $ 21,638,009
BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER INC 5.2 $ 24,105,461
BROOKLYN HOSPITAL 1.7 $ 9,452,238
BROOKS MEMORIAL HOSPITAL 1.6 $ 311,703
BRUNSWICK HOSPITAL CENTER INC 2.4 $ 3,783,932
BURKE REHABILITATION CENTER 1.3 $ (53,610)
CABRINI MEDICAL CENTER 3.5 $ 8,454,907
CALVARY HOSPITAL 1.2 $ 203,618
CANTON-POTSDAM HOSPITAL 1.4 $ 368,858
CARTHAGE AREA HOSPITAL INC 1.5 $ 443,757
CATHOLIC MEDICAL CENTER OF BROOKLYN & QUEENS, INC 2.3 $ 23,234,619
CATSKILL REGIONAL HOSPITAL - HARRIS 2.1 $ 7,066,064
CATSKILL REGIONAL HOSPITAL - HERMAN 0.9 $ 52,831
CAYUGA MEDICAL CENTER AT ITHACA 1.5 $ 546,864
CENTRAL SUFFOLK HOSPITAL 3.9 $ 5,394,032
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR 2.1 $ 2,698,022
CHENANGO MEMORIAL HOSPITAL INC 1.8 $ 1,172,936
CITY HOSPITAL CENTER AT ELMHURST 1.8 $ 11,089,143
CLIFTON SPRINGS HOSPITAL AND CLINIC 1.9 $ 355,279
CLIFTON-FINE HOSPITAL 1.1 $ 42,063
COLER MEMORIAL HOSPITAL 2.0 $ 647,642
COLUMBIA-GREENE MEDICAL CENTER 2.1 $ 2,224,374

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 Inpatient
Overcharge
Hospital Rate Total Overcharges
COMMUNITY HOSPITAL @ DOBBS FERRY 2.1 $ 302,479
COMMUNITY MEMORIAL HOSPITAL INC 1.9 $ 357,971
COMMUNITY-GENERAL HOSPITAL OF GREATER SYRACUSE 1.8 $ 1,249,260
CONEY ISLAND HOSPITAL 1.5 $ 2,653,040
CORNING HOSPITAL 1.3 $ 1,098,532
CORTLAND MEMORIAL HOSPITAL INC 1.6 $ 1,095,454
CROUSE-IRVING MEMORIAL HOSPITAL 1.8 $ 4,035,508
CUBA MEMORIAL HOSPITAL INC 1.2 $ 55,426
DELAWARE VALLEY HOSPITAL INC 1.8 $ 333,408
EASTERN LONG ISLAND HOSPITAL 2.0 $ 679,969
EDDY COHOES REHAB CENTER 1.4 $ 2,847
EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR 1.6 $ 167,956
ELIZABETHTOWN COMMUNITY HOSPITAL 1.0 $ 53,500
ELLENVILLE COMMUNITY HOSPITAL 1.1 $ 182,289
ELLIS HOSPITAL 3.3 $ 5,183,432
EPISCOPAL HEALTH SERVICES 2.1 $ 1,797,496
ERIE COUNTY MEDICAL CENTER 1.4 $ 2,288,856
F F THOMPSON HOSPITAL 1.4 $ 465,187
FAXTON - ST LUKES HEALTH CARE 2.2 $ 3,025,972
FLUSHING HOSPITAL AND MEDICAL CENTER 2.0 $ 9,572,943
FRANKLIN GENERAL HOSPITAL 2.9 $ 8,555,429
GENEVA GENERAL HOSPITAL 1.6 $ 1,238,417
GLENS FALLS HOSPITAL 2.1 $ 4,613,982
GOLDWATER MEMORIAL HOSPITAL 2.0 $ 2,067,714
GOOD SAMARITAN HOSPITAL OF SUFFERN 3.1 $ 9,604,435
GOOD SAMARITAN HOSPITAL OF WEST ISLIP 3.3 $ 15,007,726
HARLEM HOSPITAL CENTER 1.1 $ (2,792,098)
HELEN HAYES HOSPITAL 1.3 $ 8,381
HEPBURN MEDICAL CENTER 1.6 $ 1,283,414
HIGHLAND HOSPITAL OF ROCHESTER 1.3 $ 641,075
HOSPITAL FOR JOINT DISEASE - ORTHOPEDIC INSTITUTE 2.2 $ 1,262,643
HOSPITAL FOR SPECIAL SURGERY 2.4 $ 723,152
HUDSON VALLEY HOSPITAL CENTER 3.2 $ 1,872,634
HUNTINGTON HOSPITAL 2.4 $ 5,968,029
INTER-COMMUNITY MEMORIAL HOSPITAL AT NEWFANE INC 1.7 $ 200,742
INTERFAITH MEDICAL CENTER 3.8 $ 15,198,661
IRA DAVENPORT MEMORIAL HOSPITAL INC 1.5 $ 203,039
JACOBI MEDICAL CENTER 1.5 $ 467,980
JAMAICA HOSPITAL 2.0 $ 33,375,239
JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON
NEW YORK INC 3.1 $ 3,319,350
KALEIDA HEALTH 2.2 $ 13,187,911
KENMORE MERCY HOSPITAL 3.0 $ 1,264,586
KINGS COUNTY HOSPITAL CENTER 1.6 $ 9,519,641
KINGSBROOK JEWISH MEDICAL CENTER 3.5 $ 2,302,414

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 Inpatient
Overcharge
Hospital Rate Total Overcharges
KINGSTON HOSPITAL 1.7 $ 1,560,504
LAKESIDE MEMORIAL HOSPITAL 1.8 $ 326,936
LAWRENCE HOSPITAL 2.3 $ 1,878,936
LENOX HILL HOSPITAL 5.0 $ 24,366,359
LEWIS COUNTY GENERAL HOSPITAL 1.6 $ 324,474
LINCOLN MEDICAL & MENTAL HEALTH CENTER 1.3 $ (3,141,558)
LITTLE FALLS HOSPITAL 2.0 $ 562,399
LOCKPORT MEMORIAL HOSPITAL 1.6 $ 424,285
LONG BEACH MEDICAL CENTER 5.9 $ 4,236,016
LONG ISLAND COLLEGE HOSPITAL 3.3 $ 20,440,888
LONG ISLAND JEWISH-HILLSIDE MED CTR 2.6 $ 28,275,543
LUTHERAN MEDICAL CENTER 1.5 $ 12,319,231
MAIMONIDES MEDICAL CENTER 3.0 $ 29,647,343
MANHATTAN EYE EAR AND THROAT HOSPITAL 2.4 $ 3,685,945
MARGARETVILLE MEMORIAL HOSPITAL 1.5 $ 917,998
MARY IMOGENE BASSETT HOSPITAL 1.7 $ 1,751,667
MASSENA MEMORIAL HOSPITAL 1.7 $ 727,629
MEDINA MEMORIAL HOSPITAL 1.2 $ 130,949
MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES 1.5 $ 4,701,086
MEMORIAL HOSPITAL OF ALBANY 1.9 $ 1,526,325
MEMORIAL HOSPITAL OF WM F & GERTRUDE F JONES A/K/A
JONES MEMORIAL HOS 1.5 $ 135,178
MERCY HOSPITAL OF BUFFALO 2.7 $ 3,301,700
MERCY MEDICAL CENTER 2.8 $ 3,758,859
METROPOLITAN HOSPITAL CENTER 1.4 $ 302,793
MONTEFIORE HOSPITAL & MEDICAL CENTER 3.2 $ 37,116,153
MOSES-LUDINGTON HOSPITAL 1.0 $ 4,420
MOUNT SINAI HOSPITAL 2.1 $ 23,843,140
MOUNT SINAI HOSPITAL OF QUEENS 2.2 $ 4,068,237
MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS 2.3 $ 426,453
MOUNT VERNON HOSPITAL 1.9 $ 4,506,641
NASSAU MEDICAL CENTER 1.8 $ 16,602,959
NATHAN LITTAUER HOSPITAL 1.6 $ 881,191
NEW ISLAND HOSPITAL 3.5 $ 2,344,611
NEW YORK DOWNTOWN HOSPITAL 1.7 $ 1,625,711
NIAGARA FALLS MEMORIAL MEDICAL CENTER 2.1 $ 931,088
NICHOLAS H NOYES MEMORIAL HOSPITAL 2.1 $ 591,502
NORTH CENTRAL BRONX HOSPITAL 1.4 $ (1,163,899)
NORTH GENERAL HOSPITAL 1.4 $ 4,486,716
NORTH SHORE UNIV @ FOREST HILLS 2.4 $ 6,957,065
NORTH SHORE UNIV HOSP @ PLAINVIEW 2.7 $ 3,189,748
NORTH SHORE UNIVERSITY HOSPITAL 2.4 $ 26,058,641
NORTH SHORE UNIVERSITY HOSPITAL @ GLEN COVE 2.8 $ 4,891,841
NORTHERN DUTCHESS HOSPITAL 3.8 $ 1,608,315
NORTHERN WESTCHESTER HOSPITAL 1.8 $ 1,348,039

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 Inpatient
Overcharge
Hospital Rate Total Overcharges
NY COMMUNITY - BROOKLYN 2.3 $ 625,075
NY EYE AND EAR INFIRMARY 2.8 $ 4,270,827
NY MED CTR OF QUEENS 2.2 $ 9,567,314
NY METHODIST HOSPITAL OF BROOKLYN 2.7 $ 25,035,663
NY PRESBYTERIAN 2.4 $ 48,422,220
NY WESTCHESTER SQUARE MEDICAL CENTER 2.0 $ 894,274
NYACK HOSPITAL 4.2 $ 7,047,207
NYU MEDICAL CENTER 2.3 $ 5,082,077
O'CONNOR HOSPITAL 0.8 $ 53,707
OLEAN GENERAL HOSPITAL 1.9 $ 1,057,032
ONEIDA HEALTHCARE CENTER 1.7 $ 627,366
ORANGE REGIONAL MEDICAL CENTER 2.9 $ 8,147,403
OSWEGO HOSPITAL 1.5 $ 1,057,522
OUR LADY OF LOURDES MEMORIAL HOSPITAL 1.9 $ 2,263,052
OUR LADY OF MERCY MEDICAL CTR 2.0 $ 9,095,695
PARK RIDGE HOSPITAL 1.6 $ 1,436,115
PARKWAY HOSPITAL 7.3 $ 12,059,371
PENINSULA HOSPITAL CENTER 1.8 $ 465,646
PHELPS MEMORIAL HOSPITAL ASSOCIATION 2.5 $ 2,416,764
PUTNAM COMMUNITY HOSPITAL 4.0 $ 4,660,832
QUEENS HOSPITAL CENTER 1.2 $ (2,545,238)
RIVER HOSPITAL 0.8 $ 52,188
ROCHESTER GENERAL HOSPITAL 1.6 $ 5,936,266
ROME MEMORIAL HOSPITAL 2.1 $ 1,786,589
ROSWELL PARK MEMORIAL INSTITUTE 1.6 $ 372,612
SAMARITAN HOSPITAL OF TROY 2.2 $ 2,724,841
SAMARITAN MEDICAL CENTER 1.7 $ 1,546,436
SARATOGA HOSPITAL 2.4 $ 2,302,939
SCHUYLER HOSPITAL 2.0 $ 365,553
SETON HEALTH SYSTEM 2.2 $ 1,497,710
SISTERS OF CHARITY HOSPITAL 2.5 $ 2,705,549
SISTERS OF CHARITY MEDICAL CTR 2.1 $ 6,752,440
SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES
COUNTY INC 1.7 $ 317,044
SOUND SHORE MED CTR OF WESTCHESTER 1.5 $ 7,214,444
SOUTH NASSAU COMMUNITIES HOSPITAL 3.4 $ 5,371,569
SOUTHAMPTON HOSPITAL 2.6 $ 4,524,839
SOUTHSIDE HOSPITAL 3.5 $ 13,106,315
ST ANTHONY COMMUNITY HOSPITAL 3.5 $ 2,549,653
ST BARNABAS HOSPITAL 2.0 $ 8,954,294
ST CATHERINE OF SIENA 3.0 $ 2,670,045
ST CHARLES HOSPITAL 2.7 $ 2,927,269
ST CLARES HOSPITAL AND HEALTH CENTER 1.6 $ 1,182,046
ST CLARES HOSPITAL OF SCHENECTADY 1.6 $ 1,829,342
ST ELIZABETH HOSPITAL 2.0 $ 1,925,417

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 Inpatient
Overcharge
Hospital Rate Total Overcharges
ST FRANCIS HOSPITAL OF POUGHKEEPSIE 3.2 $ 5,355,919
ST FRANCIS HOSPITAL OF ROSLYN 2.7 $ 2,383,569
ST JAMES MERCY HOSPITAL 1.8 $ 1,586,241
ST JOHNS RIVERSIDE-YONKERS 2.0 $ 4,034,955
ST JOSEPH INTERCOMMUNITY HOSPITAL 3.1 $ 1,402,258
ST JOSEPHS HOSPITAL HEALTH CENTER 1.9 $ 3,850,932
ST JOSEPHS HOSPITAL OF ELMIRA 2.1 $ 1,429,289
ST JOSEPHS HOSPITAL YONKERS 1.7 $ 1,652,854
ST LUKES - ROOSEVELT HOSPITAL CENTER 2.8 $ 48,440,398
ST LUKES-CORNWALL HOSPITAL 3.3 $ 9,017,702
ST MARYS HOSPITAL AT AMSTERDAM 1.8 $ 1,277,787
ST MARYS HOSPITAL OF BROOKLYN 2.0 $ 7,626,873
ST PETERS HOSPITAL 2.8 $ 3,558,850
ST VINCENTS HOSPITAL AND MEDICAL CENTER OF NY 2.1 $ 19,820,926
STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL CENTER 1.0 $ 5,216,292
STATEN ISLAND UNIVERSITY HOSPITAL 2.9 $ 15,313,519
STRONG MEMORIAL HOSPITAL 1.7 $ 7,050,102
SUMMIT PARK HOSPITAL-ROCKLAND COUNTY INFIRMARY 1.6 $ 859,378
SUNNYVIEW HOSPITAL AND REHABILITATION CENTER 1.7 $ 32,516
SUNY HEALTH SCIENCE CENTER AT SYRACUSE 1.2 $ 575,025
THE HOSPITAL 1.9 $ 225,208
TLC HEALTH CARE NETWORK 1.7 $ 298,918
UNITED HEALTH SERVICES, INC 1.8 $ 5,162,296
UNITED HOSPITAL 1.9 $ 1,946,363
UNITED MEMORIAL 2.1 $ 1,219,680
UNIVERSITY HOSPITAL AT STONY BROOK 1.8 $ 21,722,895
VASSAR BROTHERS HOSPITAL 5.0 $ 10,702,271
VIA HEALTH OF WAYNE 2.2 $ 1,975,437
VICTORY MEMORIAL HOSPITAL 5.8 $ 6,742,451
WESTCHESTER MEDICAL CENTER 1.8 $ 4,354,311
WESTFIELD MEMORIAL HOSPITAL INC 1.5 $ 144,074
WHITE PLAINS HOSPITAL MEDICAL CENTER 2.1 $ 3,325,393
WINTHROP UNIVERSITY HOSPITAL 2.9 $ 7,142,987
WOMANS CHRISTIAN ASSOCIATION 1.8 $ 1,425,749
WOODHULL MEDICAL AND MENTAL HEALTH CENTER 1.2 $ 681,798
WYCKOFF HEIGHTS HOSPITAL 2.1 $ 9,566,153
WYOMING COUNTY COMMUNITY HOSPITAL 1.4 $ 290,889

Statewide 2.3 $1,110,137,594

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 The Great Hospital Heist: How New York Hospitals Charge the Most to those
Least Able to Pay was authored by Richard Kirsch.

© 2006 Public Policy and Education Fund of New York, 94 Central Avenue,
Albany, New York 12206; 518-465-4600. http://www.citizenactionny.org/.

Support for the Public Policy and Education Fund’s research on health
coverage issues comes from the Robert Sterling Clark Foundation.

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