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Accretive Healthcare, one of the nation's largest medical debt collectors, will be forced to pay $2.5 million to the Minnesota State attorney general for violating a law requiring hospitals to treat patients regardless of their ability to pay. Accretive is accused of having debt collectors waiting in hospital emergency rooms for patients that owe medical bills, and coercing them into paying before receiving any further emergency treatment. However, the company refuses any wrongdoing.

The Minnesota attorney general revealed hundreds of internal reports from Accretive that outlined extremely aggressive tactics to collect medical payments from patients in the emergency room. Accretive contracts with some of the largest hospitals in the country to recoup unpaid medical bills and is now barred from conducting business for two years within the state of Minnesota. The case in Minnesota uncovers a much larger problem across the nation whereby hospitals have turned to medical debt collectors at the cost of providing patient care and privacy. Although hospitals have long used medical debt collectors to collect on unpaid medical bills, patients were typically pursued outside of hospital walls. But debt collectors have become so aggressive since the recession that they will wait inside the hospital for sick and vulnerable patients that owe money.

Accretive internal training manuals and emails also showed that employees were instructed to hound patients to pay for outstanding bills and coerce them into not seeking additional care. The company also created a pressurized environment where employees were required to attend daily meetings at Minnesota hospitals and those that fell behind on collecting medical bill payments were terminated on the spot. Finally, Accretive employees also possessed a mass of confidential patient records, which they may have used to persuade these patients to pay their past due bills. This is a violation of federal privacy laws, and frightens consumer advocates that worry about the fine line between patient privacy and care and the need for hospitals to collect past due bills.

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