LaborTalk for April 26, 2012

Hospital Debt Collectors Harass Patients
To Pay Bills Before Receiving Treatment

By Harry Kelber

Hospital patients waiting in an emergency room or convalescing after surgery are being confronted by a bill collector who asks them to pay their outstanding bills to the hospital, and demanding they pay, in advance, the cost of receiving treatment.

Highly aggressive tactics have been developed by one of the nation's largest collector of medical debts. Accretive Health. Its tactics include embedding debt collectors as hospital employees in emergency rooms and demanding that patients pay before receiving treatment. It is feared such practices may become common in hospitals across the country.

In some cases, the company's employees had access to health information about patients, while persuading them to pay overdue bills, according to documents and interviews by The New York Times.

The Minnesota Attorney General, Lori Swanson, has said that Accretive employees may have broken federal privacy laws by not clearly identifying its employees as debt collectors.

PatientCare Suffers as Debt Collectors Apply Pressure

While hospital collections increased at Fairview (Minn.), patient care suffered, "Patients are harassed mercilessly," a hospital employee told the attorney general.

Patients with outstanding balances were closely tracked by Accretive staff members, who placed them on "stop lists." In March 2011, doctors at Fairview complained that such strong-arm tactics were discouraging patients from seeking life-saving treatments, but Accretive officials dismissed the complaints as "country club talk."

Ms Swanson said that the hounding of patients violated the Emergency Medical Treatment and Active Labor Act, a federal law requiring hospitals to provide emergency health care, regardless of citizenship, legal status or ability to pay.

In addition, Accreditive also violated state collections laws by failing to identify themselves as debt collectors when dealing with patients.

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Accreditive announced on April 26 that it had won a contract to provide "revenue cycle operations" for Catholic Health East, which has hospitals in 11 states.

How will hospital unions and patient rights advocates react to Accrediture's activity?

LaborTalk will be posted here on May 3, 2012 and on our two web sites: and on

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