Attorney General Lori Swanson on Tuesday released the results of her office's investigation into Fairview Health Services' relationship with a debt collection company she has accused of violating federal and state patient privacy and debt collection laws.
Swanson said the results provide further evidence that Accretive Health engaged in illegal activity.
Swanson filed a lawsuit against Accretive Health in January, and Fairview said it stopped using the company for debt collection last month. A separate contract with Accretive Health aimed at controlling the hospital system's costs remains in place, Swanson said.
The lawsuit accused Accretive Health of violating federal and state laws and showed a few examples of the detailed patient records Accretive Health's debt collectors had access to as they pursued cases.
The new details released Tuesday come from a subsequent compliance review. The new information includes scores of internal e-mails, memos and training documents.
For example, Swanson said debt collection laws say the companies collecting debts should only have access to basic information needed to collect the debts. The investigation makes clear that Accretive Health employees had detailed information about patients' diagnoses and care plans, she said.
The internal memos show Accretive Health's strategies for getting payments out of patients and detail how its employees were rewarded or punished based on collection quotas.
Swanson said the company's work with Fairview shows a culture clash; Accretive's goal was collecting payments in a place where patients should be the priority.
"Accretive has brought into the hospitals a Wall Street collection mentality whereas a hospital should be about care and human dignity," she said.
Fairview said it shares many of Swanson's concerns and has taken actions to address them.
"It is critical that our business practices align with our values and comply with applicable laws and industry standards," Fairview said in a written statement. "Fairview is committed to protecting the privacy and dignity of its patients and to acting in their best interests. We continue to evaluate issues raised by the Attorney General and will take action as appropriate."
Accretive also had a debt collection contract with North Memorial Medical Center. Swanson said she has attempted to investigate that relationship but said North Memorial officials haven't cooperated.
In a written statement, North Memorial CEO Larry Taylor said officials are providing information to the Attorney General's Office "in a manner that is as timely as possible."
"We take this matter very seriously and we are fully prepared to assist Minnesota Attorney General Lori Swanson with the investigation," he said.
Accretive Health declined to address Swanson's allegations. In a written statement, the company emphasized its work unrelated to debt collection.
"We have a great track record of helping hospitals enhance their quality of care. For example, we have helped over 250,000 patients get insurance coverage," the statement read.
The Minnesota Department of Commerce has suspended Accretive's debt collection license and is also investigating the company.
Swanson said Accretive Health, based in Chicago, has revenue cycle contracts, which include debt collection, in 60 hospitals across the country. She said it's possible other companies are using similar tactics.
"It's something new and it's something troubling," she said. "This is a case of money and medicine not mixing very well."