Various hospitals are receiving media attention not for the care they provide but because of who they are suing — namely, their own patients. In addition to a little revenue, usually arriving in small negotiated payments over a period of years, these facilities are receiving bad publicity, too.

In Virginia, 36% of hospitals sued patients and garnished their wages in 2017 (an average of $2,783), according to a recent study.1 In Connecticut, between 2011 and 2016, physician practices, hospitals, or collection agencies initiated 81,136 lawsuits in small claims courts against their patients to recover outstanding medical debts.2

“In my experience, people want to pay their medical bills,” says Andrew P. Cohen, JD, a supervising attorney with Health Law Advocates in Boston, noting that certain patients simply cannot. “The amount owed and sheer number of bills from various providers can be very intimidating and, frankly, unaffordable.”

Cohen says his firm has not seen hospitals suing patients over late bills. He attributes this to the state’s Health Safety Net as a reimbursement mechanism, significant regulation of the hospital industry under state law, and a high insured rate. On the other hand, other types of providers (such as physicians’ groups) do sue patients for uncovered medical bills. Increasingly, “skimpy” health insurance (higher deductibles, bigger copayments and coinsurance) puts more out-of-pocket burden on individuals, Cohen observes.

Better financial counseling would “absolutely help to prevent medical debt,” Cohen offers. Many people end up with medical bills because of gaps in coverage when they should have been enrolled in a public program in the first place. “Hospitals need to utilize staff more proactively to screen patients for public program eligibility,” Cohen suggests.

Screening patients in a timely manner can prevent medical debt because some programs cover bills retroactively for a limited time. “Even where a person is ineligible for public assistance, there are usually hospital-based charity care programs, even within for-profit institutions, that can help defray medical costs,” he says.

Effective screening can engage patients in affordable payment arrangements. “Medical bills can be addressed up front before landing in collections,” Cohen adds.

REFERENCES

  1. Bruhn WE, Tutkow L, Wang P, et al. Prevalence and characteristics of Virginia hospitals suing patients and garnishing wages for unpaid medical bills. JAMA 2019; Jun 25. doi: 10.1001/jama.2019.9144. [Epub ahead of print].
  2. Health Disparities Institute; Villagra VG, Felix M, Coman E, et al. When hospitals and doctors sue their patients: The medical debt crisis through a new lens. June 18, 2019. Available at: http://bit.ly/321encL. Accessed June 28, 2019.