Union hits hospital on late-night ER fee

A health care union trying to organize workers at Beth Israel Deaconess Medical Center has assailed the hospital's physician group for adding a late-night fee for patients who come to emergency rooms after 10 p.m.

Local 1199 of the Service Employees International Union drew on publicly available Medicare claims data that show patients treated by the Harvard Medical Faculty Physicians at five hospitals in the state were billed a surcharge of $30 if they were seen between 10 p.m. and 8 a.m. Besides Beth Israel Deaconess, the other hospitals are Saint Vincent Hospital in Worcester, Milton Hospital, Nashoba Valley Medical Center in Ayer, and Beth Israel Deaconess Medical Center-Needham.

The doctors' group said the fee was a common practice, comparing it to different pay rates health care providers earn for working overnight.

"Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center – and many physician groups across Massachusetts and the nation – assess a standard after-hours fee for any patient seen between the hours of 10 p.m. and 8 a.m.," Dr. Stuart Rosenberg, head of Harvard Medical Faculty Physicians, and Dr. Richard Wolfe, chair of emergency medicine at Beth Israel Deaconess, said in a statement e-mailed to the Globe today. "This fee is designed to offset the cost of 24-hour, 7-day access to emergency medical services and is compliance with state and federal law and all contracts BIDMC and HMFP have with health care insurers."

The union held a rally this afternoon outside the annual meeting of the Beth Israel Deaconess board at the Four Seasons Hotel, calling for the fees to be rolled back. During its drive to organize employees, the union has criticized the hospital and its chief executive, Paul Levy, about issues beyond employee relations.

"Consumers are seeing more fees everywhere these days, but hitting patients with a fee based on the time of their emergency crosses the line," Mike Fadel, executive vice president of 1199SEIU United Healthcare Workers East. "It’s important for these fees to be refunded before this practice spreads to other hospitals and more patients are taken advantage of in their hour of need.”

Spokesmen for Boston Medical Center, Caritas Christi Health Care, Tufts Medical Center, and Partners HealthCare, the parent of Massachusetts General Hospital and Brigham and Women's Hospital, said their hospitals or hospital-affiliated physician practices do not have such a fee.