Bellevue, Wash.-based Puget Sound Physicians will pay more than $410,000 in refunds and interest to low-income patients under an agreement with Washington Attorney General Nick Brown’s office, the Washington State Standard reported Oct. 1.
The privately held physician practice provides emergency physician services at Bellevue-based Overlake Medical Center & Clinics and bills ED patients directly. Under its contract with the hospital, the practice agreed to follow Overlake’s charity care policies, which require refunds when a patient who has already paid a bill is later found eligible for charity care.
From November 2020 through March 2026, Puget Sound Physicians failed to provide $346,983.84 in refunds to 1,406 charity care-eligible patients, according to an assurance of discontinuance filed Sept. 29 in King County Superior Court. The practice attributed the failures to unintentional accounting errors involving a third-party billing company and did not admit to violating Washington’s Consumer Protection Act. The attorney general’s office maintained the conduct constituted unfair or deceptive practices.
“Our state’s charity care laws are designed to make sure people never forgo life-saving medical care out of fear that they can’t afford it,” Mr. Brown said in a statement, according to the Standard. “When providers fail to follow the law, our consumer protection team stands up for Washington patients.”
Under the agreement, Puget Sound Physicians must begin mailing refund checks with 9% annual interest to 1,382 patients within 120 days, totaling about $410,419. Another 24 eligible patients owed $2 or less are excluded. Refunds that cannot be delivered or go uncashed will be sent to the Washington Department of Revenue’s unclaimed property program. The practice also must pay the attorney general’s office $52,500 in costs and fees and comply with the state’s charity care requirements going forward.
In a Sept. 29 news release, Puget Sound Physicians said that as a private entity, it is not directly subject to Washington’s Charity Care Act but has voluntarily honored Overlake’s charity care determinations under a private agreement. The practice said the errors affected fewer than 18% of patients who received free care during the period reviewed, and that it has provided about $2.4 million in free care to more than 7,700 patients over the past five years.
“Providing quality medical care to patients regardless of their ability to pay is a core value of Puget Sound Physicians. That commitment is precisely why we have voluntarily honored the hospital’s charity care determinations for over 30 years, even though PSP is not subject to the Charity Care Act,” a spokesperson for the practice said in the release.
The agreement is the latest in a string of charity care enforcement actions in Washington. In 2025, Wenatchee, Wash.-based Confluence Health refunded more than $1.8 million to more than 4,700 patients following an attorney general investigation. In 2024, Renton, Wash.-based Providence agreed to repay and forgive $157.8 million in patient debt to resolve a lawsuit from the attorney general’s office over its charity care practices.
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