Yesterday, Minnesota Attorney General Lori Swanson blasted the debt collection agency formerly used by Fairview hospitals for employing "boiler-room-style" tactics in trying to get emergency room patients to pay their bills upfront.
The collection agency, Chicago-based Accretive Health, was pretty much dropped by Fairview last Friday, days before Swanson went public with her concerns. Accretive still has a "business relationship" with North Memorial Medical Center.
The New York Times reports that some emergency room patients at Fairview were confronted by debt collectors at bedside and were asked to pay before receiving treatment -- a practice that Swanson alleges 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.
[jump] In a report detailing the allegations, Swanson writes: "Perhaps the most damaging act ... was to undermine the basic premise that a hospital is a sanctuary to treat the sick and infirm."
According to the Star Tribune, in one case, a child who sought treatment at the University of Minnesota Amplatz Emergency Room was kept waiting while the parents, who were uninsured, met with an Accretive "financial counselor." The incident prompted hospital employees to question whether Accretive was violating the Emergency Medical Treatment Act.
In another case, an insured woman was told by an Accretive employee that she needed to pay $876 upfront as her share of a $9,000 procedure to insert tubes in the ears of her 3-year-old son. But when she received her insurance statement, she learned she had been overcharged by nearly $700. The woman then spent two months fighting with Fairview to get the charged rescinded.
Accretive's employees dress like hospital employees, making it difficult for patients to distinguish between collectors and the medical staff. And Accretive's pressure tactics weren't just reserved for the emergency room -- a July 2010 email from Fairview employee Jena Anderberg to Accretive managers said, "We need to get cracking on labor and delivery. There is a good chunk to be collected there."
In response to Swanson's report, Fairview said it has cooperated with the attorney general and shares concerns about Accretive's practices. Accretive, which reported a profit of $29.2 million last year, said in a statement, "we have a great track record of helping hospitals enhance their quality of care."
According to the Times, Swanson hasn't yet filed suit against Accretive, but is in discussions with state and federal regulators about a coordinated response to the company's practices at hospitals throughout the country.