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May 05, 2012 01:00 AM

Fire spreads

Congress wants more on Accretive

Melanie Evans
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    Waxman and other ranking members of the U.S. House have requested specific information from Accretive Health.

    Accretive Health faces a congressional inquiry as executives moved to defend the company's business practices following a highly critical report from Minnesota's attorney general.

    After a conservative initial response to the report, released April 24, Accretive officials last week repeatedly and stridently rejected the attorney general's findings, which said the company may have violated federal privacy and consumer protection laws while under contract with Fairview Health Services, a seven-hospital system based in Minneapolis.

    Attorneys for the Chicago-based company said in a letter to the attorney general dated May 2 that “we have been investigating the issues you raised and it is clear that the innuendo and speculation in your report has resulted in significant misinformation.”

    The Minnesota attorney general alleges that Accretive aggressively sought to collect from patients as they arrived at the hospital and emergency room (April 30, p. 6). The company's collectors had access to patients' medical information, according to the report.

    Accretive said in the letter that the attorney general's report omitted information. For example, the report described the father of an emergency room patient who received information about costs before his son received treatment. The father had asked to meet with a financial consultant, the company said.

    News pushed the company's stock into a slide and prompted at least one other state attorney general to begin an investigation. Last week, members of the U.S. House announced an inquiry and briefing. Representatives from the company were scheduled to attend the closed briefing May 4.

    Reps. Henry Waxman (D-Calif.), Diana DeGette (D-Colo.) and G.K. Butterfield (D-N.C.) said the findings raise questions about whether such debt collection practices are common.

    “One of our most important questions is the extent to which these practices may be more widespread than this single health system,” the representatives said in a letter to Mary Tolan, CEO of Accretive Health.

    The House members made a far-reaching request for documents on the company's policies and practices. The request included information on compliance with federal emergency room access, patient privacy and debt collection laws. The inquiry also seeks information about employee guidance related to patient registration and collection efforts prior to treatment and how the company estimates prices and patient bills.

    The representatives also asked for a list of Accretive Health clients. The company has listed some prominent health systems among its customers, including Intermountain Healthcare and Ascension Health. Ascension, the nation's largest private not-for-profit health system, was an early investor in Accretive Health through the health system's venture capital arm.

    Another House member, Rep. Pete Stark (D-Calif.) has asked HHS and the CMS to investigate Accretive.

    The company's letter also dismissed claims that it violated federal privacy laws as “misguided” and called the Fair Credit Reporting Act inapplicable.

    The letter came days after Accretive Health asked a federal judge to throw out a lawsuit brought by the attorney general. The lawsuit was filed in January after the theft of an Accretive laptop that contained patient information.

    The attorney general “leveraged this isolated incident to pursue a wide-ranging, factually baseless and legally meritless attack against the full gambit of Accretive Health's business practices,” the company said. And Accretive started the week with a separate statement that blasted the attorney general's findings, which the company said “grossly distort and mischaracterize” its services.

    The Minnesota attorney general's office defended its report as “accurate and documented by the facts.”

    “The compliance report is based on the review of over 100,000 pages of documents and interviews and discussions with many people, including officers and directors of Fairview,” the attorney general's office said in a written statement.

    Patients reported aggressive debt collection efforts by Accretive, the attorney general's office said, and the company “continues to ignore the dignity and rights of those patients” with its statement to the press.

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