Better Solutions for Healthcare

KHN: College Tuition Sparked a Mental Health Crisis. Then the Hefty Hospital Bill Arrived.

By Jordan Rau

February 26, 2021

Despite a lifelong struggle with panic attacks, Divya Singh made a brave move across the world last fall from her home in Mumbai, India. She enrolled at Hofstra University in Hempstead, New York, to study physics and explore an interest in standup comedy in Manhattan.Arriving in the midst of the covid-19 pandemic and isolated in her dorm room, Singh’s anxiety ballooned when her family had trouble coming up with the money for a $16,000 tuition installment. Hofstra warned her she would have to vacate the dorm after the term ended if she was not paid up. At one point, she ran into obstacles transferring money onto her campus meal card.

“I’m a literally broke college student that didn’t have money for food,” she recalled. “At that moment of panic, I didn’t want to do anything or leave my bed.”

In late October, she called the campus counseling center hotline and met with a psychologist. “All I wanted was someone to listen to me and validate the fact that I wasn’t going crazy,” she said.

Fresenius Medical Care is one of the most prominent fixtures in the dialysis industry and provides medical supplies to dialysis clinics and home dialysis patients across the globe. Over the past several years, it has been exposed to significant liability over its use of certain drugs during the dialysis process. These drugs, specifically known as Naturalyte and Granuflo, were recalled by the FDA in March 2012 over safety concerns. It was later revealed through a leaked internal memo that Fresenius was aware of the increased risk of cardiac arrest linked to these drugs and even knew about 941 cardiac incidents involving these chemicals. It wasn’t until the FDA’s recall occurred that Fresenius issued its own warning to dialysis centers as to the dangers of these drugs. The company is facing ongoing wrongful death and personal injury liability from these fraudulent cover-ups.

Fresenius and several other dialysis companies agreed to pay over $80 million to settle allegations of improper Medicare billing for home dialysis services in 2012. Many of these companies maintain internal auditing and compliance procedures. However, when the Department of Justice performed its investigation, it discovered that the companies’ own records revealed that nearly all records pertaining to Medicare or Medicaid patients were missing from the files.

Instead, when she mentioned suicidal thoughts, the psychologist insisted on a psychiatric evaluation. Singh was taken by ambulance to Long Island Jewish Medical Center in New Hyde Park, New York, and kept for a week on a psychiatric ward at nearby Zucker Hillside Hospital. Both are part of the Northwell Health system.

The experience — lots of time alone and a few therapy sessions — was of minimal benefit psychologically, she said. Singh emerged facing the same tuition debt as before.

And then another bill came.