The Cache County Mayors' Association wants Intermountain Health Care to explain "irregularities" in the way many patients have been billed at Logan Regional Hospital.

The 19 mayors also want a statement showing the "income and profit" of the hospital - one of 24 hospitals owned by IHC Inc., a not-for-profit health-care conglomerate with headquarters in Salt Lake City, according to the Associated Press."The mayors' association has gone on record stating they believe there are inequities in IHC's policy decisions on how they bill," Logan Mayor Russ Fjeldsted later told the Deseret News. "We are concerned like everyone else with the high cost of medical care and would like to have a forum with the local hospital board."

Charles Doane, administrator of the Logan Regional Hospital, said the hospital administration is eager to cooperate with the mayors.

"We have not received an official invitation from the association to meet with them, but we are happy to discuss with them the concerns that have been expressed," he said Monday. "We are trying to address their concerns. We don't want a battle with anyone."

In Cache County, the hospital's practice of "cost-shifting" is in question. The mayors say hospital administrators blame the practice for some of the "irregularities."

At last week's meeting of the mayors' association, River Heights Mayor John Stewart said the mayors want information on this policy."

Stewart said "cost-shifting" means some patients are billed for services they do not receive to cover costs that can't be collected from other patients.

"We believe this is dishonest, unethical, illegal and reprehensible," he said. "We recognize that Logan Regional is not the only hospital in the Intermountain Health Care system indulging in this practice, but that does not make it acceptable."

Doane said Stewart's explanation is incorrect.

"I don't understand that statement. We do not bill patients for what they don't receive," he said.

Doane said the hospital does participate in "cost-sharing." According to the Utah Hospital Association, that's a practice adopted by most hospitals - including those not owned by IHC.

"When a patient comes in and is unable to pay the cost of his medical care, it is shifted to other paying patients," Doane said. In other words, the hospital tries to spread the cost of unpaid bills to paying patients and insurance "We are concerned like everyone else with the high cost of medical care and would like to have a forum with the local hospital board."companies. Or, the hospital writes it off. "This is not unique to IHC. It is a very difficult problem for everyone - how to handle those who are unable to pay."

Doane said that practice is needed to help fund quality health care for all sectors of society. "If we did not have this policy, we would not be able to provide care to people in this service area with the inability to pay," he said.

The concerns of the mayors' association aren't new.Stewart said he told Doane last summer that an investigation by the mayors' group was forthcoming and that the mayors had listed "cost-shifting" as one of their top priorities.

"He did meet with me and indicated there were concerns and wanted us to address those," Doane said.

IHC has been under scrutiny by several county governments and citizens and business watch-dog groups. In light of escalating health-care costs, the groups are questioning the corporation's tax-exempt status.

IHC has appealed several tax assessments before the Utah Supreme Court, and the Utah Tax Commission is writing guidelines to help counties decide whether non-profit hospitals should pay property taxes.

IHC argues it shouldn't pay property taxes because last year alone it made a "more than $100 million" contribution to the community through free medical care to the needy, unreimbursed care, subsidies to government health programs and support of education programs and health screenings.

Stewart and Hyde Park Mayor Robert Balls attended a meeting of the hospital board on Oct. 3. Balls is also association vice president.

"We were disappointed at the defensive attitude we found there, even though we assured them we were not questioning the quality of service or the hospital personnel," Stewart said, according to the Associated Press. "We are only questioning the charges made to patients and their insurance companies by a tax-exempt organization which is placing an increasing financial burden on Cache Valley people."

Stewart said in addition to the cost-shifting on some patients' bills, the investigation has revealed that drugs cost several times more at the hospital than at pharmacies.

"Unless he has specifics, that's hard to respond to," Doane said.

At the request of Fjeldsted, the mayors' group has agreed to have someone from the hospital administration meet the mayors at their November meeting.

"I believe we should start a dialogue because they haven't had a chance to come to the association and explain their side of the story," Fjeldsted said. "I believe we owe them a right to provide answers to the questions we have."