UVA Medical Center Dan Addison

The University of Virginia Health System continues to revamp its billing and collection practices after a report in The Washington Post that uncovered aggressive tactics that left thousands of patients—even some of the system’s own employees—facing mounting bills and lawsuits.

According to the investigation by nonprofit news service Kaiser Health News, the health system and its doctors filed more than 36,000 lawsuits to recoup more than $106 million from former patients in the six years ending in June 2018. The lawsuits sought to recover a wide range of debt—from $13.91 to as much as $1 million—during most of that time period, according to the report.

The article detailed how the health system had placed liens on homes and property, garnished paychecks, seized state tax refunds and blocked UVA enrollment for students who owed money. The practices, according to the story, led some UVA patients and their families to financial ruin.

Four days after the article was published in September, the health system announced it would change its practices, including pledging to reduce medical bills for low-income patients and those without insurance. Officials also said they would find “workable repayment plans” for patients instead of relying on the legal system for debt collection.

UVA Health announced the formation of a community advisory board at the end of October. In a news release, Dr. Chris Ghaemmaghami, the UVA Medical Center’s chief medical officer and interim CEO, said he looks to the group of civic leaders, social services providers and UVA health care faculty, students and staff to recommend “additional ways we can better serve our patients as well as improve fairness and transparency.”

President James E. Ryan (Law ’92) says he learned of the controversy a month before the story broke. “I’m sorry it took patients and families suffering to bring this to our attention, but it’s leading to real change,” he says via email. He adds, “To me, the sign of being great and good is, when you discover a problem, you address it honestly, and that’s what the health system is doing now.”

Among the adjustments, the health system said, it will provide some extra relief for patients who owe money and earn at or below 400 percent of the federal poverty line, or about $50,000 for an individual and $103,000 for a family of four. UVA stopped short of saying it would discontinue filing lawsuits, but said it will sue only in cases where people earning more than 400 percent of the federal poverty level owe more than $1,000, “absent unusual circumstances.”

The changes will go into effect Jan. 1 with more actions to come, according to the announcement. Leaders say they will look for other ways to improve billing and collections, including how UVA Health sets its prices.