Health Care

Missouri AG investigating complaints about health-sharing ministry that targets KC

Jeff Gore said he was drawn to sign up with Medical Cost Sharing Inc. because of the religious iconography on is website. But after his experience with the company refusing to pay his medical claims, Gore said he’s come to believe it’s just a marketing ploy.
Jeff Gore said he was drawn to sign up with Medical Cost Sharing Inc. because of the religious iconography on is website. But after his experience with the company refusing to pay his medical claims, Gore said he’s come to believe it’s just a marketing ploy.

When Jeff Gore and his wife started looking at health-sharing ministries two years ago, he was drawn in by the website of Medical Cost Sharing Inc. in St. Joseph.

The ministries are groups of people united by religious beliefs who agree to share each other’s medical bills. Members send monthly pledges to a central fund that is tapped when one of them has a qualifying medical need.

Pictures of crosses, praying hands and Bible verses dotted nearly every page of the Medical Cost Sharing website. Gore, a “cowboy minister” from Texas who travels to rural churches preaching the Gospel and playing music, liked what he saw and signed up.

“Their website said all the right things,” Gore said.

But the Gores are now part of a group of at least eight people who say Medical Cost Sharing Inc. took their money, but never paid out a dime for medical treatments. Some of their complaints have reached the office of Missouri Attorney General Josh Hawley, which is trying to determine whether Medical Cost Sharing should pay restitution.

“We’re in the mediation process on that issue,” said Hawley’s spokeswoman, Loree Anne Paradise.

Paradise said she could not say more about it.

Medical Cost Sharing’s co-founder and chief operating officer, James McGinnis, said the organization is on the up-and-up, has paid some medical bills and is working to resolve things with Hawley’s office.

Health-sharing ministries predate the Affordable Care Act, or Obamacare, by decades but have burgeoned in popularity since the law passed in 2010. The ministries are exempt from Obamacare’s coverage requirements, and their members are exempt from the law’s penalties for not carrying insurance.

But the ministries are not insurance and are not subject to insurance regulations that ensure legitimate medical claims get paid. Members have to go on faith, and critics of health-sharing ministries say that leaves them vulnerable to fraud or incompetent management.

McGinnis’ group was established in July 2013, according to Missouri incorporation documents. His business partner, Craig A. Reynolds, is a former insurance agent who had his license revoked in both Kansas and Missouri in 2009.

Medical Cost Sharing is open to customers nationwide but has a second website specifically targeted to the Kansas City market.

McGinnis said the company is trying to give consumers more options as insurers like Blue Cross and Blue Shield of Kansas City flee the Affordable Care Act markets.

“Health care in this country is in a lot of trouble,” McGinnis said. “We’re going to end up being one of the only games in town.”

Medical Cost Sharing will have to resolve some compliance issues first. Health sharing ministries are required to be 501(c)(3) charitable nonprofits, but according to the IRS, Medical Cost Sharing’s nonprofit status was automatically revoked in May 2016 for failing to file an annual Form 990 three years in a row.

“We are in the process of getting that reinstated,” McGinnis said. “There was a deadline that was missed, and we’re going back and fixing that.”

Then there are the attorney general proceedings, which stem from complaints made by Gore and three others that were obtained through an open-records request.

Gore filed his complaint in September.

He said that after about five months of Medical Cost Sharing membership, he ended up in a doctor’s office last year with knee pain and, after an MRI, was diagnosed with a torn meniscus.

He said Medical Cost Sharing never paid either of the medical providers, and he’s seeking to recoup nearly $4,000 in monthly membership fees.

“I don’t figure I’ll ever get a dime, but I’m dang sure going to try,” Gore said in a phone interview.

An open records request filed with Hawley’s office showed that others also contacted the attorney general with concerns about Medical Cost Sharing’s legitimacy.

Craig Kraeger of Thornton, Colo., said he was a Medical Cost Sharing member from February 2016 to May 2017 and started to have doubts about it after an emergency room visit in December.

“The way this company has handled my medical bills has made me very suspicious of their operations,” Kraeger said in his complaint. “Medical Cost Sharing could very well be a legitimate business and actually share costs of members’ medical costs. I don’t see the transparency that shows me that they actually do this.”

Kraeger urged Hawley’s office to investigate.

Rob Harris of Austin, Texas, lodged a short complaint in February saying Medical Cost Sharing is “an illegal cost-sharing ministry” in part because it was operating without nonprofit status.

“They do not meet the requirements to be a faith-based health care sharing ministry” under Obamacare, Harris said.

The most detailed complaint sent to Hawley’s office came from Sean Parnell, a Virginia-based health policy economist and consultant. Parnell wasn’t a Medical Cost Sharing member, but he studies health care-sharing ministries and told the attorney general that the information on the company’s websites “raises a number of red flags.”

Parnell said the term “insurance” was sprinkled throughout the sites, while most ministries are careful to disclose that they are not insurance. He also said the websites made “false claims” about the Affordable Care Act tax penalties for being uninsured, and he flagged Reynolds’ license revocations and the company’s failure to file its IRS forms.

Parnell also said Medical Cost Sharing was trying to re-appropriate another company’s 24-hour nurse hotline.

“I hope you can quickly investigate this matter and take any appropriate action,” Parnell wrote in the complaint filed in September.

Parnell did not respond to an emailed request for comment.

But a blog post he wrote publicly detailed the concerns he raised with the attorney general’s office. An update to the original post says that after it was published, Medical Cost Sharing made several changes to its websites that addressed some of his concerns and removed the nurse hotline, which belonged to St. Joseph medical provider Mosaic Life Care.

Mosaic vice president Michael Rinard, in a statement released Friday morning, said Medical Cost Sharing’s advertising of the hotline was unauthorized.

“Mosaic Life Care has no affiliation with this company and the Mosaic Life Care nurse hotline is free to the community,” Rinard said. “Mosaic Life Care will pursue possible legal action against the party advertising our hotline as their own.”

There were dozens of reader comments left on the bottom of Parnell’s blog post, including six by people who said they were Medical Cost Sharing members and had nonpayment complaints similar to Gore’s.

One commenter said he had a great experience with Medical Cost Sharing.

McGinnis said all of the health care-sharing ministries have had unsatisfied customers and that “people are going to file complaints.”

“Like anything else, you cannot please all of the people all of the time,” McGinnis said.

As premium rates are being set for the next Affordable Care Act open-enrollment period this fall, McGinnis said Medical Cost Sharing is getting lined up to offer an alternative to buying insurance through the Obamacare exchange.

“We have some very good attorneys that are working on things,” McGinnis said. “We will have everything just exactly the way that everybody wants it to be this year.”

Gore said people shouldn’t buy what Medical Cost Sharing is selling.

“Whether they are Christians or just claim to be, they’re using that to just rip people off,” Gore said. “They know there’s people like me that will be suckered in that way.”

Andy Marso: 816-234-4055, @andymarso