In Congress, a Move to Look Into a Medical Debt Collector

A California representative is calling for an investigation into Accretive Health, one of the nation's largest collectors of medical debt, for potentially violating a federal law that requires hospitals to provide emergency care regardless of citizenship, legal status or the ability to pay.

The congressman, Pete Stark, a Democrat who is the highest ranking member of the subcommittee that oversees Medicare and other health services, on Thursday asked Marilyn B. Tavenner, the acting administrator for the Medicare and Medicaid agency, to investigate the company's practices.

He sent an identical letter to the inspector general of the Department of Health and Human Services, Daniel R. Levinson.

In an interview, Mr. Stark said that he was most alarmed about Accretive's tactics of demanding that patients seeking emergency care pay outstanding balances before receiving treatment. Mr. Stark said he was spurred to action after reading about Accretive's practices in an article in The New York Times on Wednesday.

"The behavior is potentially criminal," said Mr. Stark, who wrote the Emergency Medical Treatment and Active Labor Act, the law mandating that hospitals provide care even to patients who are unable to pay for it.

Accretive Health declined to comment.

On Tuesday, the Minnesota attorney general disclosed hundreds of Accretive's internal documents, obtained through a six-month investigation, which raised concerns about aggressive debt-collection practices that may be prevalent at hospitals across the country.

Shares of Accretive Health plunged nearly 42 percent on Wednesday, and a further 2.3 percent Thursday, to close at $10.50.

Accretive Health has contracts with more than 50 hospitals. The attorney general's revelation on Tuesday highlighted a range of aggressive tactics employed by Accretive, including embedding debt-collection employees in emergency rooms and hounding patients for payment before receiving treatment. Doctors in Minnesota where Accretive has contracts raised alarms that the company's strongarm tactics might be discouraging patients from seeking emergency care, the documents show.

Beyond these collection tactics, Lori Swanson, the Minnesota attorney general, accused the company of potentially violating patient privacy laws by furnishing its debt-collection employees with confidential patient health records.

Ms. Swanson's investigation stems from a lawsuit she filed against Accretive in January after an employee's laptop was stolen containing more than 23,500 patient health records.

Accretive reported $29.2 million in profit last year, up 131 percent from 2010. In its annual report, the company said it was cooperating with the attorney general to resolve the issues in Minnesota.

In a brief statement on Tuesday, it said, "We have a great track record of helping hospitals enhance their quality of care."