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Consumers Battle Against Hospital-Owned Debt Collectors

A Florida woman’s life was thrown into turmoil after she was hospitalized and received a massive bill that she couldn’t pay. According to Bloomberg:

[Angelia] Fowler had been sick for months in November 2015 when her son finally took her to the emergency room with what turned out to be pneumonia. She spent much of the next month in a coma in intensive care at St. Mary’s Medical Center in West Palm Beach, Florida. 

The bill arrived in January. After discounts, the hospital wanted her to pay $80,770. Other bills from specialists boosted the sum she owed above six figures, enough to buy a condo in West Palm Beach. It was a sum she couldn’t pay.

Shortly thereafter, a collections agency reported her debt to credit agencies, which ruined her credit and cost her jobs. She was surprised to learn that the debt collectors and hospital that had saved her life are owned by the same entity.

Though Fowler didn’t realize it, St. Mary’s Medical Center and Central Financial Control are both owned by Tenet Healthcare Corp., the for-profit hospital operator. As Tenet and other hospital companies struggle to make money providing medical care, they are turning to the profitable and growing business of collecting debt.

Most hospitals have finance departments or outside companies that try to ensure they get paid by insurers and patients. But Tenet has gone a step further than most, turning its operation into a separate business line called Conifer and contracting its services to other medical providers.

Tenet and its debt collection agency, Conifer, have been fined for its practices in recent years and been the subject of hundreds of consumer complaints over the last four years.

Tenet’s practices have drawn backlash from patients and regulators for years. In June 2015, the Consumer Financial Protection Bureau ordered Conifer to pay $5 million in relief to consumers. The regulator said it failed to send consumers proper documentation and didn’t adequately respond when debts were disputed.

The bureau has recorded 889 consumer complaints about Tenet since 2013, including 358 so far in 2017. Many don’t mention the hospital company directly but refer instead to Central Financial Control or Syndicated Office Systems.

Tenet is not the only hospital operator turning to the collections business to boost their profits.

HCA, the nation’s largest for-profit hospital chain, has a subsidiary called Parallon that boasts on its website about collecting $41 billion annually. MedNax Inc., a company that provides staffing to hospitals for such services as anesthesiology and neonatal intensive care, purchased a billing and collections company in 2015.

While there are many consumers like Fowler who are unable to pay their medical debt, few options are available to them.

The amount of past-due medical debt in the U.S. is about $75 billion, spread among 43 million people, according to estimates from economists at MIT, Northwestern University and the University of Chicago. About half of all collections lines on credit reports are related to medical debt, a 2014 report from the Consumer Financial Protection Bureau showed.

Fowler, who is uninsured and doesn’t qualify for Florida’s Medicaid program, has had to resort to reaching out to a nonprofit organization in hopes of getting her debt forgiven. She alleges the hospital did not discuss her payment options at the time of her treatment and that she has been unable to set up a payment plan after being discharged.

“They said nothing to me. I just got this giant bill in the mail,” she said. “I’m very grateful that you saved my life. But does our health care have to decimate us financially? It’s destroying me.”


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