UVa Medical Center


The University of Virginia has claimed it is legally obliged under state provisions to use “aggressive” methods to collect medical debt. Various experts have taken issue with this claim, pointing to a subsequent provision that clarifies the collection methods should be “reasonable.”

Following criticism of its debt collection methods, the University of Virginia Health System has established an advisory council to help determine new billing and collections practices.

The Billing and Collection Practices Advisory Council, which was announced by UVa on Monday, consists of 16 members from a swath of communities, including the faith-based community, schools, health care and UVa students and employees.

Karen Waters-Wicks, community education coordinator for Albemarle County Public Schools, will serve as the council’s facilitator, while Elizabeth Beasley, director of community partnerships for the UVA Health System, will serve as the council’s staff member.

According to a news release, Health System officials hope the council will help leadership better understand the impact of current and proposed billing and collections practices on low-income, uninsured and under-insured patients.

This latest move follows an announcement last month that UVa will adjust its financial aid guidelines to offer free and low-cost care to more patients.

This all comes in the wake of a report by Kaiser Health News that found that UVa had sued patients 36,000 times for more than $106 million from 2013 to June 2018. In the weeks since the report, the university has non-suited — meaning a case is dismissed but could be brought again at a future date — a slew of cases in Albemarle County General District Court.

UVa has not, however, pledged to halt all lawsuits against patients, claiming state agencies are legally required to collect unpaid bills, something it plans to advocate the General Assembly change.

One of the newly appointed council members, Michaela Lieberman, who works as a health justice legal fellow for the Legal Aid Justice Center, said she has seen the impact aggressive debt collection has on families.

“I knew the methods UVa used to collect unpaid medical debt were affecting a lot of families, but I had no idea it was as widespread as it was,” she said, referring to the KHN report.

Lieberman said she is hopeful the newly established council will help get “everything out on the table” by bringing together people from throughout the larger community who can speak to different impacts UVa’s debt collecting methods have.

Including medical professionals and others providers involved in treatment on the council also could be a wise move, she said.

“Hopefully, this will help put UVa in a position to understand exactly what this looks like, and not just on an individual level,” Lieberman said. “As providers, they’re looking to give all the best medical care they can and don’t necessarily think about what it’s costing the individuals.”

Also named to the advisory council is community activist Don Gathers. Unlike some of the other members of the council, Gathers does not come from a medical background but has seen firsthand the adverse effect UVa’s debt collecting methods can have.

“I know people who have lost their family homes after loved ones passed and they were unable to pay the medical debt,” he said. “It’s bothersome to see, because throughout this UVa hasn’t been a very good partner to much of the Charlottesville community.”

UVa has claimed it is legally obliged under state provisions to use “aggressive” methods to collect medical debt. Various experts have taken issue with this claim, pointing to a subsequent provision that clarifies the collection methods should be “reasonable.”

Gathers said he hopes the council can help to establish what is reasonable by also considering what is morally responsible.

“Just because you have a hammer doesn’t mean you have to look at everything as a nail; just because you can do something doesn’t mean you should” he said. “There has to be a way forward that’s workable for all parties involved.”

The creation of the council comes just weeks after Virginia Commonwealth University pledged to no longer pursue legal action to collect medical debts, issue new garnishments on wages or put new liens on homes.

According to a UVa news release, the advisory council will begin its work this month by reviewing the council’s objectives, discussing the impacts of the Health System’s billing and collection policies and practices and determining ways to improve communication with the community.

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