Debt Collector Is Faulted for Tough Tactics in Hospitals

From:
http://www.nytimes.com/2012/04/25/business/de ... ner=rss&emc=rss

"Debt Collector Is Faulted for Tough Tactics in Hospitals
By JESSICA SILVER-GREENBERG
Published: April 24, 2012


One of the nation’s largest medical debt-collection companies is under fire in Minnesota for having placed its employees in emergency rooms and other departments at two hospitals and demanding that patients pay before receiving treatment, according to documents released Tuesday by the Minnesota attorney general. The documents say the company also used patient health records to wrangle for more money on overdue bills.

The company, Accretive Health, has contracts not only with the two hospitals cited in Minnesota but also with some of the largest hospital systems in the country, including Henry Ford Health System in Michigan and Intermountain Healthcare in Utah. Since January, it has faced a civil lawsuit filed by Attorney General Lori Swanson of Minnesota alleging that it violated state and federal debt-collection laws and patient privacy protections.

Ms. Swanson, though not bringing further charges on Tuesday, said she was in discussions with state and federal regulators to prompt a widespread crackdown on Accretive Health’s practices in other states.

“I have every reason to believe that what they are doing in Minnesota is simply company practice,” she said in an interview, but declined to be more specific.

An Accretive Health spokeswoman  declined to comment on whether other states were looking into its practices. “We have a great track record of helping hospitals enhance their quality of care,” she said.

But hundreds of internal company documents released by the attorney general’s office cast a spotlight on the increasingly aggressive medical-collection techniques used against patients at hospitals across the country.

As a growing number of hospitals struggle under a glut of unpaid bills, they are turning to companies like Accretive. To win promised savings, all hospitals have to do is turn over the management of their front-line staffing — ranging from patient registration to scheduling and billing — and their back-office collection activities. Accretive says it has such arrangements with some of the country’s largest hospital systems to help reduce their costs.

Indistinguishable from medical staff members, Accretive employees register patients, take down sensitive health information and champion aggressive bill collection goals with incentives like gift cards for staff members, the company records show.

“It is absolutely stunning that the company has systematically trampled on patient rights, perverting the charitable mission of a hospital,” Ms. Swanson said in an interview.

Accretive is one of a group of debt-collection companies specializing in health care collection. Last year, the publicly traded company reported $29.2 million in net income, up 130 percent from a year earlier.

In its pitches to hospitals, Accretive boasts that it trains its staff to focus on getting payment. Employees in the emergency room were told to ask incoming patients first for a credit-card payment. If that fails, employees are told to say, “If you have your checkbook in your car I will be happy to wait for you,” internal documents show.

In July 2010, a manager at Accretive told staff members at Fairview Health Services, a Minnesota hospital group, that they should “get cracking on labor and delivery,” since there is a “good chunk to be collected there,” according to internal company e-mails.

As part of its collection strategy, Accretive fostered a boiler-room environment at the hospitals it works with, according to hospital employees and the newly released documents.

While hospital collections increased, patient care plummeted, the employees said. “Patients are harassed mercilessly,” a hospital employee told Ms. Swanson. Another hospital employee complained, “We were told if we don’t get money from patients, in the emergency room, we will be fired.”

Accretive debt-collection employees, calling themselves “financial counselors,” are instructed by the upper management ranks to stall patients entering the emergency room until they have agreed to pay a prior balance, according to the documents.

Patients with outstanding balances are closely tracked by Accretive staff members, who list them on what employees refer to as “stop lists,” internal documents show. 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,” the documents show.

It is not clear how many times the “stop lists” induced patients seeking emergency care to leave the hospital.

By giving its collectors access to health records, Accretive violates the Health Insurance Portability and Accountability Act, colloquially known as HIPAA, Ms. Swanson said. For example, an Accretive collection employee had access to records that showed a patient had bipolar disorder, Parkinson’s disease and a host of other conditions.

Collection employees also discussed a patient’s cancer, speculating about whether the condition was “terminal or disabling,” company e-mails show.

This article has been revised to reflect the following correction:

Correction: April 24, 2012

An earlier version of this article misstated a measure of Accretive Health’s financial performance. Last year the company reported net income — not revenue — of $29.2 million. An earlier version also misspelled the name of Marcia Newton’s son. His name is Maxx, not Max."

Jeee-zo Crapso .... It's very hard for debt collection stunts to surprise me, but this did it. We have doppelganger medical clerks and a hospital admin willing to look the other way and whistle as both HIPAA rights and critical care are denied. Plus, if this does not scream "unfair and deceptive practice" as defined by the FDCPA, we have some deaf and dumb authorities.

If ever I bust a limb within 100 miles of an Accretive client, I think I'll just fashion a splint from scrap wood and take my chances at home.

Holy ****!!
Now we have to inquire about the employees?!
This is inconceivable! And beyond the pale!

We're living in an Ayn Rand Paradise. Get used to it.

Does the Hospital issue these Gestapo agents official hospital ID's????  

I think perhaps they would clash with the swastika armbands and the cute death's head jewelry, but then I am no fashionista.

What would Karl Marx say?  Better yet, what would Groucho Marx have to say??

...While hospital collections increased, patient care plummeted, the employees said. “Patients are harassed mercilessly,” a hospital employee told Ms. Swanson. Another hospital employee complained, “We were told if we don’t get money from patients, in the emergency room, we will be fired.”...

They are also violating the EMTALA (Emergency Medical Treatment and Active Labor Act), by harassing patients for payment and interfering with their care:

"1.Individuals requesting emergency care, or those for whom a representative has made a request if the patient is unable, must receive a medical screening examination to determine whether an emergency medical condition (EMC) exists. The participating hospital cannot delay examination and treatment to inquire about methods of payment or insurance coverage, or a patient's citizenship or legal status. The hospital may only start the process of payment inquiry and billing once they have stabilized the patient to a degree that the process will not interfere with or otherwise compromise patient care".

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

Can you spell "malpractice"?  I'm sure a lot of personal injury lawyers can.    If Accretive Health malfeasance resulted in delay in treatment and subsequent harm to patients, both they and the hospitals could looking forward to a long day in court, especially if violations of law occurred as well.

It bears repeating:

The participating hospital cannot delay examination and treatment to inquire about methods of payment or insurance coverage, or a patient's citizenship or legal status. The hospital may only start the process of payment inquiry and billing once they have stabilized the patient to a degree that the process will not interfere with or otherwise compromise patient care".

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

If Sebelious does not act and throw Accretive out on their ear, I am sure that an attorney will be interested in filing a lawsuit against them in Federal court for interfering with their client(s) care.

This article helps to sum up Accretive's violations of HIPPA and EMTALA nicely:

Be careful – that nice nurse over there might actually be a debt collector.

Accretive Health, one of the country's largest collectors of medical debt, provides onsite collection services for some of the largest hospital systems in the US. According to an April 24, 2012 story in the New York Times, Minnesota Attorney General Lori Swanson thinks some of the tactics used by Accretive are aggressive and in some cases illegal. These tactics include:

•embedding Accretive employees in hospital emergency rooms and demanding that patients pay before receiving treatment;

•embedding Accretive employees in labor and delivery rooms;

•Accretive employees discouraging patients who have a previous balance from seeking emergency care, or stalling them in the emergency room until they pay;

•Accretive employees giving the appearance of being hospital employees when they were not, in violation of the law; and:

•In some cases, Accretive employees had access to health information in addition to billing information, a possible violation of federal privacy laws.

http://www.thelangelfirm.com/Debt-Defense-Blo ... alth-Attor.aspx

That is just fudged up.

This story sums up very well why tort reform only benefits the perpetrators, and leaves the non-negligent patients at their mercy.  Here, the HIPPA privacy violations are miles beyond egregious, and deserving of legal compensation - let's hope no one sustained any injuries from malpractice committed by the hospital or its agents.

Original Business Start Date: January 2005
Principal: Mr. Steve Walters, Vice President
Customer Contact: Mr. Steve Walters, Vice President - (866) 249-2094
Type Of Business: Collection Agencies
BBB Accreditation: This organization is a BBB Accredited Business.
Additional DBA Names: Accretive Health
Incorporated: January 2005, DE
Entity: Partnership
Employees: 170

Pasted from <http://www.debt-consolidation.com/collection- ... cial-solutions/>

MN attorney general complaint April 2012

Accretive listed “Medical Financial Solutions” as an assumed name according to the MN attorney general complaint April 2012, page 1.

http://www.ag.state.mn.us/PDF/PressReleases/ComplianceReview/Vol.%205.pdf

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA LAWSUIT

http://www.ag.state.mn.us/PDF/Consumer/AccretiveHealth20120119.pdf


Accretive Health Debt Collector Defends Embedding Employees Inside Hospitals

Pasted from <http://www.huffingtonpost.com/2012/05/11/accr ... _n_1509329.html>

Debt Collector Is Faulted for Tough Tactics in Hospitals

Pasted from <http://www.nytimes.com/2012/04/25/business/de ... -hospitals.html>

ATTORNEY GENERAL SWANSON SUES ACCRETIVE HEALTH FOR PATIENT PRIVACY VIOLATIONS, as of 1/19/2012

Pasted from <https://www.ag.state.mn.us/Consumer/PressRelease/120119AccretiveHealth.asp>

Accretive is licensed as a debt collection agency in Minnesota.  Last year it raised over $100 million in a public securities offering.  As noted above, Accretive Health is a portfolio company of Accretive, LLC, a Wall Street private equity fund with a controversial history in Minnesota relating to the arbitration and collection of consumer debts.  In 2009 the Minnesota Attorney General’s Office sued the National Arbitration Forum—the nation’s largest consumer credit arbitration company—for telling consumers and courts that it independently and neutrally decided consumer credit cases when, in fact, it was affiliated with a New York private equity fund that owned the major debt collection enterprise that filed cases with the Forum.  That equity fund was Accretive, LLC, and it set up the enterprise in which it simultaneously took control of the nation’s largest debt collection enterprise and became affiliated with the Forum.  In the wake of the lawsuit, the National Arbitration Forum was banned from arbitrating consumer credit disputes, and the debt collector owned by Accretive, LLC shut down.  Accretive, LLC (the master equity fund), however, survived, and Accretive Health is one of its portfolio companies.

Pasted from <https://www.ag.state.mn.us/Consumer/PressRelease/120119AccretiveHealth.asp>

More Lawsuits

Norberg v. Medical Financial Solutions

Pasted from <http://dockets.justia.com/docket/michigan/miwdce/1:2011cv00346/66117/>


Blose v. Medical Financial Solutions et al

Pasted from <http://dockets.justia.com/docket/vermont/vtdce/2:2010cv00271/19699/>

Colbert v. Medical Financial Solutions

Pasted from <http://dockets.justia.com/docket/michigan/miwdce/1:2010cv00762/63680/>

Crump v. Medical Financial Solutions

Pasted from <http://dockets.justia.com/docket/michigan/miwdce/1:2010cv00656/63360/>