RALEIGH, N.C. (WNCN) – A new report by the state treasurer’s office released Wednesday says nonprofit hospitals in North Carolina are billing poor patients at a rate “three times the national average,” as some state lawmakers said they’re looking into new legislation to address the issue.

The report, which was compiled by the North Carolina State Health Plan and the National Academy of State Health Policy, found the hospitals billed nearly $150 million to patients who likely qualified for charity care under the hospitals’ policies.

However, that only accounts for 16 percent of hospitals that reported the information.

“I wish we weren’t here,” said state Treasurer Dale Folwell (R). “This is really happening right in front of our eyes.”

The report says in 2019 “between 12% and almost 30% of hospital bad debt belongs to patients eligible for charity care.” The report says those figures were likely higher in 2020 due to the COVID-19 pandemic but could only get a “small sample of data” for that year.

“Medical debt is the debt most likely to lead North Carolinians to bankruptcy,” said state Sen. Jay Chaudhuri (D-Wake).

The report notes some hospitals have sued patients or offered them credit cards that eventually charge high interest rates.

Based on documents provided by various hospital systems, WakeMed was the only large system where the amount spent on charity care exceeded the value of tax breaks received in 2020, the report notes. WakeMed also says all uninsured patients are “personally” contacted by a financial counselor.

Dr. Vivian Ho, an economics professor at Rice University who reviewed the data included in the report, said a significant challenge researchers face is that there’s inconsistency in what information hospitals report.

“Clearly there are severe problems in terms of data transparency that there are so many hospitals that are failing to report all the required information. So, that puts North Carolinians at a disadvantage,” she said.

Hospitals have varying standards on who qualifies for charity care and different thresholds at which people qualify based on their income.

The North Carolina Healthcare Association, which represents the state’s hospitals, criticized Folwell for highlighting the issue amid the latest surge in COVID-19 cases in a statement released to CBS 17.

“Attacking and demonizing hospitals while their exhausted employees are working 24/7 to meet a pandemic peak in hospitalizations is distracting, disrespectful and potentially dangerous,” the NCHA said.

The association said the report fails to account for the community benefit hospitals provide and does not account for the “true cost and toll that COVID-19 has taken on hospitals,” noting that’s resulted in $3 billion in unforeseen expenses.

The group added, “Is the hospital affordability, billing, and payment system as a whole broken? Yes, all the stakeholders should work together to improve it. Government programs like Medicare and Medicaid pay hospitals less than the cost of caring for the beneficiaries; insurance companies negotiate deep discounts with hospitals, and many people who are uninsured pay little or nothing at all.”

Folwell spoke about his own experience when he was hospitalized in March 2020 as the COVID-19 pandemic began.

“This is not about the people who actually do the work of healthcare, the people who squeezed my hand, who got me through ICU,” he said. “This is about the multi-million-dollar executives who run these multi-billion-dollar corporations who disguise themselves as non-profits.”

A bipartisan group of state lawmakers addressed the issue Wednesday, saying there should be more state oversight and reforms to hold hospitals accountable, though it’s not clear what specific changes they’ll pursue.

“The big problem is we don’t have the information. The hospitals are saying we do that. Well, my challenge to them is show us you do it,” said Sen. Jim Burgin (R-Harnett).