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House Democrats, HHS Investigate Alleged Debt Collection Violations

May 5, 2012—House Energy and Commerce Committee Ranking Member Henry Waxman (D-Calif.) joined the ranking members of the Oversight and Commerce Subcommittees, Reps. Diana DeGette (D-Colo.) and G.K. Butterfield (D-N.C.), in a May 2 letter launching an investigation into reported “aggressive debt collection efforts”  by Accretive Health, Inc. The Chicago-based company offers “revenue cycle management” services to hospitals and other health care facilities.

Addressed to Accretive Health CEO Mary Tolan, the letter raised concerns about possible Emergency Medical Treatment and Labor Act (EMTALA), privacy, and fair debt collection violations by the company’s collection agents. The committee members have scheduled a May 14 briefing by Ms. Tolan, who has been asked to answer a range of questions outlined in the letter.

Among the information requested by the committee members is a list of the hospitals and health care facilities that have contracted with Accretive. They also requested information about collection efforts “imposed” prior to a patient’s medical treatment, the company’s alleged use of protected patient information “for revenue-related purposes,” and their policies and procedures related to their “proper estimation” of health care service costs and prices.

Also, at a May 2 briefing with Attorney General Eric Holder regarding unrelated Medicare fraud schemes, Secretary of Health and Human Services (HHS) Kathleen Sebelius acknowledged that they “have been made aware of” allegations against some “aggressive contractors working on behalf of hospitals” who allegedly confront patients in the hospital setting without “making it clear that they were actually bill collectors and not part of the hospital system.”

On April 26, Energy and Commerce Health Subcommittee Ranking Member Pete Stark (D-Calif.) sent a related letter to Inspector General Daniel Levinson and Centers for Medicare and Medicaid Services (CMS)  Acting Administrator Marilyn Tavenner requesting their investigation of Accretive’s collection practices. If such practices violate federal law, Rep. Stark asked Levinson and Tavenner to circulate immediately a bulletin or other communication clarifying the illegality of such practices to all Medicare-participating hospitals. He also asks that they warn hospitals of “possible enforcement action.”


Christiane Mitchell
Senior Director Health Care Affairs
Telephone: 202-828-0461


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