Hospitals in Minnesota, and possibly elsewhere in the country have sunk to a new low in their debt-collection practices by employing collectors in emergency rooms, as well as labor and delivery rooms to pressure patients into paying up. The Minnesota attorney general revealed that Accretive Health, one of the nation's largest collectors of medical debt, regularly embedded debt collectors among hospital employees. The collectors, who looked like regular employees and sometimes had access to patients’ medical files, would demand payment before patients received treatment and sometimes discouraged them from getting emergency care at all.

Via:

Employees at Accretive’s client hospitals ask patients to make “point of service” payments before they receive treatment. Until she went to Fairview for her son Maxx’s ear tube surgery in November, Marcia Newton, a stay-at-home mother in Corcoran, Minn., said she had never been asked to pay for care before receiving it. “They were really aggressive about getting that money upfront,” she said in an interview.

Ms. Newton was shocked to learn that the employees were debt collectors. “You really feel hoodwinked,” she said.

While hospital collections at Fairview increased, patient care suffered, the employees said. “Patients are harassed mercilessly,” a hospital employee told Ms. Swanson.

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

The attorney general, Lori Swanson, cited two federal laws that are violated by Accretive's practices, 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, and that by giving its collectors access to health records, Accretive violated the Health Insurance Portability and Accountability Act.

Swanson further cited a state law that is broken when Accretive employees fail to identify themselves as debt collectors when accosting patients.

And don't assume that you need not worry about being confronted by debt collectors if you visit not-for-profit hospitals. The New York Times reports that just this week "Accretive announced it won a contract to provide “revenue cycle operations” for Catholic Health East, which has hospitals in 11 states."