BOSTON, March 26, 2026 /PRNewswire/ -- PatientRightsAdvocate.org (PRA), along with George Washington University Law School and Stanford University's Clinical Excellence Research Center released a new academic report analyzing 15 years of Virginia court records, revealing a coordinated "medical debt ecosystem" in which hospitals, law firms, and courts collectively extract billions from patients.

"We found that over the past 15 years, hospitals and their networks in Virginia have filed more than 1.15 million lawsuits against patients related to unpaid medical bills," said Cynthia Fisher, Founder and Chairman of PatientsRightsAdvocate.org. "In their most vulnerable hour, patients faced undue challenges, such as unclear pricing, difficulty understanding their medical bills, and unexpected legal action for debts they could not afford. Without consistent price transparency, patients often had limited ability to anticipate or verify costs, leaving many families under significant financial strain. In total, $1.4 billion in medical debt has been collected in Virginia during this time. The widespread practice of suing patients underscores the importance of strengthening price transparency policies to ensure that patients are informed and hospitals are held accountable for unfair pricing tactics. That is why Congress should act now to pass the bipartisan Patient Deserve Price Tags Act, which would bring much-needed transparency and accountability to healthcare pricing and help protect patients from these harmful practices."

From 2010–2024, hospitals and providers filed 1.15 million lawsuits against patients to collect $1.4 billion in medical debt, generating hundreds of thousands of wage garnishments at a time when healthcare affordability is top of mind for many Americans.

"Our Virginia analysis echoes what we previously found in two other states. American workers' paychecks and bank accounts too often fall prey to unethical medical bill collection practices," said Stanford physician and professor Arnold Milstein. "We hope our findings trigger much stronger protection by lawmakers, state bar associations and or employers ASAP."

Key findings:

• Nonprofit hospitals filed the majority of lawsuits, despite receiving tax exemptions tied to providing community benefit.
• A small network of 20 law firms filed more than half of all cases, frequently obtaining default judgments that trigger wage garnishments.
• Patients were often sued over bills tied to prices they were never shown up front, with the same procedures varying by as much as 77× between hospitals.

"The report illustrates just how widespread medical debt collection is: how much it accounts for all debt collections; how many hospitals, doctors, and lawyers they involve; and how they follow patients for years after requiring medical care," said George Washington University Law School professor Barak Richman. "We aptly describe it as an economic vortex and as an ecosystem of coercive collection."

About PatientRightsAdvocate.org:
PatientRightsAdvocate.org (PRA) is a leading national healthcare price transparency organization dedicated to ushering in systemwide transparency through advocacy, testimony, media, legal research, and grassroots campaigns. PRA believes that the availability and visibility of actual, upfront healthcare prices will greatly lower costs for patients and employers through a functional, competitive healthcare marketplace.

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SOURCE Patient Rights Advocate