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The Obamacare Scare: Medical Debt Collectors in Scrubs?

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Do you remember where you were last Thursday morning when every network interrupted its regular programming to announce the most anticipated Supreme Court decision since Bush v. Gore? It was not in the same category as the Kennedy assassination or Neil Armstrong’s “giant leap for mankind” moment, but when it was reported that Chief Justice John Roberts wrote the majority opinion in the Affordable Care Act case that saved Obama’s individual mandate — the centerpiece of the legislation — time seemed to stand still, breaths were held and pundits and spinmeisters alike began dancing and whirling about like delirious dervishes.

There were the predictable high-fives at the White House; the “When I am elected, my first act on my first day in office will be to dismantle this legislative abortion (forget that I passed it in Massachusetts)” messaging of the Romney campaign; and the “We’ll maim this mother before the end of the legislative term this year,” coming from the NoMads — those icons of the Politics of No, the “I’m mad as Hell” folks from the Tea Party.

After this past week, few are willing to prognosticate what will happen in November, just as literally no one would have predicted that the Chief Justice would have been the voice of the majority in the National Federation of Independent Business v Sebelius case.

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Free Tool: Credit Report CardBut if by some chance through the trick-or-treat of a fickle November day, Mitt Romney and the Sons of the SuperPACs carry the election and are given the opportunity to gut the Affordable Care Act, I call upon them now to leave certain provisions in place — in particular those that protect Americans from the lowest of the bottom feeders in the current system: medical debt collectors.

Under the ACA, there are a few little known provisions governing financial assistance, billing and collection practices. One of them limits the ability of medical debt collectors to harass patients in need of medical assistance during the screening and admittance process and collect on previous unpaid medical bills (Mark Rukavina outlined these provisions on Credit.com in a great piece titled, “How Obamacare Keeps Debt Collectors Out of Hospitals“). 

What does it say about us as a nation where patients waiting in an emergency room or lying in (or near) recovery rooms after surgery can be confronted by a special “relative” or friend at their bedside. I am not talking about Aunt Susie or Uncle Bob. It’s your friendly embedded (didn’t they only do that with reporters in Iraq?) medical debt collector who is holding their own special brand of Get Well bouquet in the form of an invoice.

The Attorney General of Minnesota was not amused when reports surfaced that a company had slipped collectors disguised as employees into emergency rooms demanding that patients cough up dough before receiving treatment.

I understand that our hospitals are desperate to recoup an estimated $39 billion for unpaid services but what kind of world do we live in where collectors masquerading as hospital employees, perhaps in possession of personal medical information, demand that the feeble, ill, and even the dying pay outstanding medical bills they could not afford in the first place before seeking emergency care. Does the phrase “Physician do no harm” not apply when a bill is due?

[Related Article: Warning: Medical Debts CAN Hurt Your Credit]

It’s bad enough that the lowest rung of the collection food chain mercilessly pursue financially challenged patients once they have left a medical facility but to embed them into admitting, obstetrics, labor and delivery rooms as well as registration and scheduling functions where private patient information resides is quite another.

The FTC recently went after one collector for insecure collection and retention practices. It is my sense that information security and ethical practices may not necessarily be the prime directive of some debt collectors.

Reports have surfaced that patients are being asked for “point of service” payments before receiving treatments, as well as some being discouraged from seeking lifesaving treatments. Some of these folks, in documents proffered by Minnesota’s attorney general, recount tales of credit card payment requests and/or kind offers of waiting for patients to get their checkbooks out of their cars before service is rendered.

In response to two emotionally charged hearings he held in recent months, Senator Al Franken has introduced legislation to prevent debt collectors from approaching patients in emergency rooms, delivery wards and intensive care units and requiring health providers to take steps to protect patient medical information.

His legislation will extend to all hospitals existing Treasury Department regulations under the ACA banning debt collection activities in the emergency departments of federally subsidized hospitals. Further, his legislation would require health care providers to encrypt laptops and other portable devices that store patient health information — the favorite souvenir of medical identity thieves preying on the carelessness of health care workers or debt collectors.

Big things happened in America these past seven days. It still seems unlikely to me that Romney and the spawn of the John Birch Society and their latter day “dittoheads” stand any real chance of dismantling what Chief Justice Roberts (one of their heretofore heroes) so correctly preserved last week, but on the off chance the “NoMads” get a little more juice in Washington this fall, we must not allow them to undo all the good that has been accomplished over the past two years. Or at the very least, let’s all agree on a common enemy, because nobody really likes debt collectors anyway, do they?

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