The University of Minnesota Medical Center, a Fairview Health Services hospital, is at risk of being terminated from Medicare and Medicaid after regulators concluded its aggressive billing practices violated federal patient-protection laws.
Inspection documents reveal how Fairview violated federal law by employing hostile bill-collection tactics, saying both patients and their relatives were subjected to “abuse and harassment.”
For example, investigators learned a woman who believed she was having a heart attack was solicited for payment by an administrative employee the day of her treatment, the Star Tribune reported.
This “point of service” technique, according to the Star Tribune, is how employees say their superiors demanded they collect revenue.
Their scripts came from Accretive Health, a Chicago-based consulting firm that joined with Fairview in 2010 and was banned from operating in Minnesota in July.
According to documents from the investigation, an Accretive employee outlined his tactics by telling another collector in an email, “I make the deadbeats feel like [expletive], talk nicely to women who sound educated/have money, and am firm with dumb [expletive.]”
He went on to say, “eventually the people who can pay will grow tired of us continually calling and just pay to get us off their backs.”
Documents also reveal emergency room staff drafted a letter stating that they were “told that if we don’t get money from patients in the Emergency Room, we will be fired.”
The investigation details how Accretive escalated pressure to collect payment in 2010 by preparing a “heat map” identifying the University’s hospital as particularly poor at collecting prior balances in the emergency room.
Minnesota Attorney General Lori Swanson began probing the firm last September, when one of its laptops containing unencrypted data on 23,500 Minnesota patients was stolen, according to the Star Tribune.
In addition to Accretive demonstrating a “loose and cavalier” treatment of patient data, the investigation concluded the firm had “hidden its true identity from patients, aggressively and illegally attempted to collect debts from patients, improperly used patient health information to collect debts, and failed to follow basic laws regarding the registration and conduct of its collectors.”
The review also found Fairview guilty of violations of a federal “anti-dumping” law preventing hospitals from transferring poor patients without examination or stabilization.
With Accretive gone, federal regulators are holding Fairview accountable for patient mistreatment.
Stella French, director of the Office of Health Facility Complaints at the Minnesota Department of Health, said the hospital has time to avoid the sanctions by enacting changes.
So far, it has stopped collecting past-due balances, co-insurance payments and co-pays in emergency departments, according to the hospital’s statement. It also claims to have taken steps to assure the “prompt attention” of patients.
Minnesota Hospital Association spokeswoman Wendy Burt told the Star Tribune she had never heard of a Medicare contract being terminated and that the threat usually sufficed to kick-start corrective action.
Fairview is working with Centers for Medicare and Medicaid Services to resolve the issues, President Carolyn Wilson said in a statement provided to the Star Tribune.
“We continue to learn from this experience,” she said.
The Associated Press contributed to this report.