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In letter to Franken, Accretive denies violating EMTALA


By Melanie Evans
Posted: May 12, 2012 - 11:00 am ET
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In comments to U.S. Sen. Al Franken (D-Minn.), Accretive Health rejected a recent report that suggested the healthcare billing and collection company violated emergency-room access, patient privacy and debt collection laws.

Accretive's 29-page comment letter (PDF) came in response to questions from the senator following a highly critical report from Minnesota's attorney general on Accretive's business practices. The report said Accretive employees, under contract for Fairview Health Services, sought payment from emergency room and hospital patients before or as they sought care.

Under the Emergency Medial Treatment and Labor Act, emergency room patients must be seen and stabilized prior to discussion of payment. "We note the Minnesota attorney general has not brought any claims against Accretive Health for violation of EMTALA, and we believe that our policies and practices are in full compliance with EMTALA and have not identified any EMTALA violation in our investigation to date,” Accretive wrote.

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The company outlined Accretive and Fairview policies in response to Franken's questions, which sought information about when hospital, emergency room and maternity patients were asked for payment and whether patients were left with the idea they would not be treated without payment. The company said its training and scripts stressed that patients should never be denied care or be given the impression they would not be treated.

Accretive addressed questions about its post-treatment debt collection efforts as well. Minnesota Attorney General Lori Swanson said the company's collectors had access to sensitive patient information. Collectors had access to an "easily understood description of the diagnosis code” for patients, the company said. Accounting software used by Fairview prior to its Accretive contract taking effect did not restrict access to patient information but the company began to limit its employees' access eight months into the Fairview contract, Accretive said.

Comments also addressed the theft of an unencrypted laptop with patient information that led to a lawsuit from Swanson's office in January. Accretive has filed a motion to dismiss the lawsuit.

The stolen laptop lacked encryption because of "oversight of an individual IT employee" who has been terminated, the company said. Accretive has since required multiple employees to verify computer encryption.

In a letter that accompanied the comments to the senator, Gregory Kazarian, the company's senior vice president, wrote: "Accretive Health's mission to help patients and healthcare providers is one we are always refining, and if even a single patient believes he or she has not received proper, compassionate assistance from Accretive Health, that is one too many. We recognize that a company of our size cannot be perfect. But we are always looking for ways to learn and improve our contribution to the patient experience."


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