Hospitals Earn Little From Suing For Unpaid Bills. For Patients, It Can Be 'Ruinous'

When patients can't afford to pay their medical bills, many hospitals offer a payment plan — or free or discounted care. But some try to collect by suing patients and garnishing their wages.
Deshia Smith says she only realized she'd been sued over her hospital bill when she saw her paycheck was being garnished. "I literally have no food in my house because they're garnishing my check," she says. Source: Olivia Falcigno/NPR

The Fredericksburg General District Court is a red-brick courthouse with Greek columns in a picturesque, Colonial Virginia town — a horse and carriage are usually parked outside the visitor center down the street.

On a sunny morning — the second Friday in June — the first defendant at court is a young woman with glasses in a plaid purple shirt. Daisha Smith, 24, arrives early — she has just come off working an overnight shift at a group home for the elderly. She's here because the local hospital sued her for an unpaid medical bill — a bill she didn't know she owed until her wages started disappearing out of her paycheck.

The hospital, Mary Washington, sues so many patients that the court reserves a morning every month for its cases.

Inside the courthouse, it's not hard to figure out where to go. Right through court security, there are signs on colored paper: "If you are here for a MW case, please register at the civil window." When the elevators open, there's another Mary Washington sign. Wearing name badges, Mary Washington billing staff members walk through the halls. They've set up a kind of field office in a witness room at the back of the courtroom, where they are ready and waiting to set up payment plans for defendants.

On June 14, only a handful of the 300 people summoned to court show up. Most of the lawsuits were filed by the hospital, along with some others from medical companies affiliated with Mary Washington Healthcare.

The hundreds that did

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