Report: Fairview’s Billing Practices Violated Federal Law

The University of Minnesota Medical Center reportedly risks termination from Medicare and Medicaid, but a state official says there’s still time for the hospital to correct its deficiencies—and Fairview claims to have made changes that address concerns.

Regulators have concluded that heavy-handed billing practices at the University of Minnesota Medical Center violated federal patient-protection laws, according to a Star Tribune report.
The hospital is owned by Minneapolis-based Fairview Health Services—and the findings stem from Fairview’s relationship with Chicago-based consulting firm Accretive Health, Inc.
Given the findings, the University of Minnesota Medical Center risks termination from Medicare and Medicaid, which is the strongest penalty that the federal government can impose, according to the Star Tribune. However, a state official still investigating on behalf of the agency that runs Medicare told the Minneapolis newspaper that the hospital still has time to correct its deficiencies and avoid sanctions.
According to the Star Tribune, Fairview officials said Wednesday that they “have been working diligently” to address the concerns of the Centers for Medicare and Medicaid Services (CMS). The hospital added that CMS has already accepted one of its “corrective action” plans.
The Star Tribune obtained federal inspection documents showing that the University of Minnesota Medical Center repeatedly violated government rules by subjecting patients and their relatives to “abuse and harassment” during bill-collection attempts in the emergency room, the labor and delivery area, and other wards. Investigators reportedly found that in one instance, a patient who believed she was having a heart attack was told that she owed $672 for services that she had received so far that day.
Regulators reviewed medical records covering 21 cases and interviewed patients or their representatives, the Star Tribune reported. In a third of those cases, the hospital “failed to protect and promote each patient’s rights to be free from all forms of harassment when the hospital utilized aggressive payment collections tactics at the point of patient care,” investigators reportedly said. Additionally, the hospital failed to respond promptly to patient grievances in four of 14 cases that were reviewed.
The incidents are tied to Fairview’s hiring of Accretive Health, which it brought on as a revenue consultant in 2010.
In July, Accretive agreed to pay nearly $2.5 million into a patient restitution fund and cease operations in Minnesota for at least two years in order to settle a lawsuit filed by Minnesota Attorney General Lori Swanson, who accused the company of breaking privacy and debt-collection laws. Accretive has repeatedly denied Swanson’s allegations, and in its settlement agreement, the company did not admit to any wrongdoing.

Fairview cut ties with Accretive in April and subsequently chose not to renew the contract of CEO Mark Eustis, who was reportedly instrumental in hiring Accretive.
According to the Star Tribune, as the federal review was being conducted, a Fairview manager and 10 registration employees told investigators that Accretive trained hospital employees in techniques to maximize revenue collection at the “point of service” and threatened termination if collection quotas were not met.
Meanwhile, Fairview claims to have made changes in response to Swanson’s concerns and those of the federal government, and it expects “to be found in full compliance” when follow-up site visits are completed, according to the Star Tribune. In a statement provided to the newspaper, the hospital system that it has stopped collecting past-due balances, co-insurance payments, and co-pays in emergency departments. It has also reportedly worked to ensure that complaints from employees and patients receive “prompt attention” and has revised the training for hospital billing employees to ensure that “every patient interaction reflects Fairview core values” and that patient refunds are promptly issued.