BRISTOL, Conn. 鈥 Many hospital systems in Connecticut have stopped suing their patients over unpaid bills, stung by criticism about the harm caused by aggressive collection tactics.
But physicians, dentists, ambulance companies, and other health care providers are still taking their patients to court, a Connecticut Mirror-麻豆女优 Health News investigation of state legal records shows.
Lawsuits by doctors and other nonhospital providers now dominate health care collections in Connecticut, the records show, accounting for more than 80% of cases filed against patients and their families in 2024.
That鈥檚 a major reversal from just five years earlier, when hospital system lawsuits made up three-quarters of health-related collection cases in the state鈥檚 courts.
The shift is moving medical debt collections into a less regulated realm. Most hospitals, because they are tax-exempt nonprofits, must make financial aid available to low-income patients and follow federal regulations that limit aggressive collection activities. Other medical providers, such as private medical groups, are generally exempt from these rules.
The lawsuits are typically over bills of less than $3,000, but the impact on patients can be devastating. Lawsuits are among the most ruinous byproducts of a health care debt problem that burdens an estimated 100 million people in the U.S.
Lawsuits can lead to garnished wages, liens on homes, and hundreds of dollars of added debt from interest and court fees. They also pile additional financial strains on struggling families, prevent patients from getting needed care, and sap trust in medical providers.
鈥淚t鈥檚 really messed up,鈥 said Allie Cass-Wilson, a nurse in Bristol, Connecticut, who was sued over a $1,972 debt by an OB-GYN practice where she鈥檇 been a patient years earlier. 鈥淗ow can they do that to people?鈥 She did not contest the lawsuit, court records show.
Cass-Wilson, who is 36 and lives in a small apartment just off an expressway on-ramp, said she learned of the outstanding debt only when she was sued. When she tried making an appointment, she said, she was told her doctor wouldn鈥檛 see her. 鈥淭hey said I was blacklisted,鈥 Cass-Wilson said. 鈥淚 was so confused. I couldn鈥檛 believe that my medical provider let my care be interrupted like this.鈥
Cass-Wilson ultimately sought medical care elsewhere.
Radiologists, Dentists, Ambulances
Overall, CT Mirror and 麻豆女优 Health News identified more than 16,000 health care-related debt cases in Connecticut courts from 2019 to 2024. The database was assembled from online court records with the help of January Advisors, a data science consulting firm that helped extract and sort the data.
Over the six-year period, most of Connecticut鈥檚 more than 25,000 did not pursue patients in court for outstanding balances.
But records show that more than 400 medical providers, including several hospital systems, sued their patients. Among those filing lawsuits were radiologists, anesthesiologists, eye doctors, podiatrists, allergists, and pediatricians.
Dentists, periodontists, and other dental providers filed more than 1,000 lawsuits against patients. And ambulance companies sued more than 140 people.
Med-Aid, a company based outside New Haven, Connecticut, that provides orthopedic braces and other medical supplies to patients, sued more than 400 people, the court records show. The company鈥檚 president, Frank Dilieto, did not respond to repeated interview requests.
Cass-Wilson was sued by Briar Rose Network in Bristol, Connecticut, a member of a large network of OB-GYN practices across Connecticut called Physicians for Women鈥檚 Health. The network鈥檚 members sued close to 100 patients in 2024, records show.
Paula Greenberg, CEO of Women鈥檚 Health Connecticut, a private equity-backed company affiliated with Physicians for Women鈥檚 Health that manages business operations for the network, said the lawsuits represent a small fraction of the more than 300,000 patients the network sees every year.
鈥淭his is an organization committed to patients,鈥 Greenberg said. She noted that the group offers options to help patients pay, including installment plans and financial aid.
Geoffrey Manton, president of Naugatuck Valley Radiological Associates, said his practice also will work with people who say they can鈥檛 pay. But, he said, patients sometimes stop responding to their bills.
鈥淗iding from your problems isn鈥檛 going to solve them,鈥 Manton said. 鈥淚f we didn鈥檛 take any action, there could be that person that is in that late-model Mercedes that just chooses not to pay any bills.鈥 The group sued more than 125 patients from 2019 to 2024, according to the court records.
Many medical providers say that aggressive collections stem from the growing prevalence of high-deductible health plans that leave patients with thousands of dollars of bills before their coverage kicks in.
Greenberg and Manton said each of their physician groups must collect. 鈥淭his is a business,鈥 Greenberg said. 鈥淲e have to look at our operating costs.鈥
Critics of medical collection lawsuits note that the patients are typically sued over relatively small debts that are likely to have little impact on multimillion-dollar medical practices.
The average patient debt that members of Physicians for Women鈥檚 Health sued over in 2024 was less than $1,100, court records show. The physician group鈥檚 annual revenues are typically in the tens of millions of dollars, according to Greenberg.
Even relatively small debts 鈥 which often include interest 鈥 can place substantial burdens on families struggling to keep up with their bills, especially while dealing with a serious illness, patient advocates say.
鈥淲e don鈥檛 have a realistic choice in using health care,鈥 said Lisa Freeman, who heads the Connecticut Center for Patient Safety and has advocated for patients struggling with medical bills. 鈥淭o then get sued for it, when people have less and less funds available for anything extra, that鈥檚 very disheartening.鈥
A Stroke, Then a Lawsuit
Matthew Millman, 54, lost his job as an IT support worker after having a stroke. Then Meriden Imaging Center sued him over an $1,891 bill.
Millman and his wife said they tried to explain their financial situation to the center, which is affiliated with Midstate Radiology Associates, a large physician group that operates imaging centers and doctors鈥 offices across Connecticut.
鈥淚t was very frustrating,鈥 said Millman, who lives in an aging apartment owned by his wife鈥檚 family in New Britain. Millman, his wife, and their teenage daughter are barely getting by on his two part-time jobs 鈥 one bagging groceries, the other helping homebound seniors. Together, the jobs pay about $1,500 a month, he said.
The imaging center, after winning the collection case against Millman, tried to garnish his wages, though that was unsuccessful because Millman had lost his IT job.
鈥淚t鈥檚 all about money,鈥 Millman said, shaking his head. 鈥淚f you are trained in helping somebody with their health, it shouldn鈥檛 be about the money first. It should be about their health.鈥
Court records show that Midstate Radiology, Meriden Imaging Center and affiliates filed more than 1,000 collection lawsuits against patients from 2019 to 2024, making them the most litigious nonhospital providers in the state. As is common in medical debt lawsuits, the plaintiffs prevailed in most cases, records show.
Midstate president Gary Dee, a radiologist, didn鈥檛 respond to emails and messages left at his West Hartford office.
Across town from Millman鈥檚 apartment in New Britain, Joseph Lentz lives in a cramped apartment with his wife and daughter. He used to oversee operations at a Boy Scout camp but is now unemployed. Lentz lost his job during the pandemic. The family home went into foreclosure, he said.
In 2023, Orthopedic Associates of Hartford sued Lentz over a $3,644 bill the practice said he owed after having shoulder surgery in 2018.
鈥淚鈥檇 pay it if I could, I guess,鈥 said Lentz, 59. 鈥淏ut I don鈥檛 even know where next month鈥檚 rent is coming from. I鈥檓 trying to climb out as best I can. I guess this is just one more thing to shovel in.鈥
The orthopedic group filed more than 580 lawsuits against patients from 2019 to 2024, prevailing in most, records show.
The medical group declined interview requests. But chief executive David Mudano said in a statement: "As an independent physician practice, we strive to balance compassion for patients with the financial responsibility required to sustain our practice.鈥
Old Debts and Disputed Claims
Lentz, who did not contest the lawsuit, said he has no reason to doubt he owes the debt. But in many cases reviewed by CT Mirror and 麻豆女优 Health News and in interviews, patients being sued questioned the accuracy of their medical bills, citing care they thought health insurance should have covered or, in some cases, bills for services they never received.
This reflects with aggressive collection tactics like lawsuits when disputes over the accuracy of medical bills and delayed or denied insurance claims are so widespread in American health care.
A by the federal Consumer Financial Protection Bureau found that nearly half of the medical debt complaints fielded by the agency involved bills that consumers said were erroneous in some way or that consumers said they鈥檇 already paid.
鈥淲e know people are billed incorrectly,鈥 said Lester Bird, who studies debt collection lawsuits at the nonprofit Pew Charitable Trusts. Bird noted that courts are ill equipped to sort through disputed medical charges or insurance claims, especially when there is little documentation in most debt collection lawsuits.
鈥淚t鈥檚 complicated before it gets to the courts,鈥 Bird said, 鈥渁nd it鈥檚 very complicated when it gets into the courts.鈥
This can create headaches for physicians and other providers. But billing problems ultimately affect patients and their families most, said Connecticut state Sen. Saud Anwar, a Democrat who is also a physician. 鈥淧atients are left to deal with it.鈥
Andrew Skolnick, an attorney in Milford, outside New Haven, was sued in 2023 by an imaging center where his wife had received services in 2020.
Skolnick said that when the couple, who were covered through his job-based insurance, originally received the bill from Diagnostic Imaging of Milford, he tried to tell the imaging center it had submitted the claim to the wrong insurance plan, but he said they wouldn鈥檛 speak with him.
The center later filed the lawsuit, alleging he owed more than $2,000, plus almost $300 in interest.
Despite interview requests, officials at Diagnostic Imaging of Milford did not comment for this article.
Unlike most patients who are sued, Skolnick had the resources and expertise to contest the suit. He said he offered to pay what would have been his responsibility under the plan if the imaging center had filed his claim correctly. He ultimately settled for $1,700, court records show.
鈥淚t wasn鈥檛 a tremendous amount, but I knew that they had made a mistake,鈥 Skolnick said. 鈥淭he system is not working.鈥
More Protections?
Anwar, the state lawmaker and physician, expressed concern that lawsuits undermine patients鈥 faith in their doctors.
鈥淚t鈥檚 a sacred relationship,鈥 he said. 鈥淚f your physician, who is taking care of you, is suing you for money, that鈥檚 a problem.
Many hospitals, facing bad publicity from suing patients, have stopped taking patients to court over unpaid bills. Hospital collection lawsuits identified by CT Mirror and 麻豆女优 Health News in Connecticut court records plunged from more than 4,900 in 2019 to fewer than 300 in 2024.
Also, in recent years, several states, including Connecticut, have expanded protections for patients with bills they can鈥檛 pay.
Connecticut now from consumer credit reports, and legislators are pushing to get hospitals to provide more financial aid to patients. Other states have restricted the use of wage garnishment and property liens to collect medical debt.
But state efforts to rein in aggressive medical debt collections have mostly focused on hospitals. That may need to change, said Connecticut state Sen. Matt Lesser, a Democrat who co-chairs the legislature鈥檚 Human Services Committee.
He is a key backer of a bill that would bar hospitals from billing patients who receive public benefits like food assistance or who make less than twice the federal poverty level, about $32,000 for an individual.
The restriction would not apply to bills from physicians and other nonhospital providers, however. 鈥淲e may have to go bigger if that鈥檚 where the heart of the matter is,鈥 Lesser said.
Connecticut Gov. Ned Lamont, a Democrat who spearheaded an initiative to for more than 150,000 state residents, also expressed concern about physicians suing the people in their care.
鈥淓veryone should do the right thing by patients,鈥 he said.
This article was produced in partnership with , a statewide nonprofit newsroom that covers public policy and politics.
How We Did It: Analyzing Connecticut Health Care Debt Collection Lawsuits
How often do health care providers sue patients over unpaid bills?
In most states, that鈥檚 nearly impossible to answer because courts don鈥檛 typically identify which debt collection lawsuits involve a medical debt versus other kinds of debt, such as rent, credit cards, or cellphone bills.
But Connecticut is different. Debt collection cases filed in small-claims court for unpaid medical or dental bills must be classified as health care debt. We worked with the data science consulting firm January Advisors to pull these cases from the Connecticut court database and analyze them. (January Advisors has worked with nonprofits and researchers across the country to collect debt collection data from state courts. The firm did not have any editorial input in our project.)
We started with health care collection cases filed in small-claims court from 2019 to 2024. But this covered only cases involving debts smaller than $5,000. We also wanted to know about cases in which providers sued for bills exceeding $5,000. Connecticut courts don鈥檛 assign a 鈥渕edical鈥 category for large-claim cases. So we pulled all large-claim records for any plaintiff 鈥 hospital or nonhospital provider 鈥 that appeared in medical small-claims cases. We also included cases with plaintiffs that didn鈥檛 appear in that dataset but had common medical terminology in their names, like 鈥渉ospital鈥 or 鈥淒DS.鈥
We then went through each case manually to confirm that the plaintiff was a medical or dental provider. We determined whether the provider was part of a larger hospital or physician group. And we categorized each plaintiff by a provider type (e.g., hospital system, dental, physician group).
In some cases, the data we pulled was incomplete, so we looked up the court records online and manually entered the information into our database. The Connecticut Judicial Department purges case records from its online portal after a certain amount of time. In those cases, we asked the agency to provide summonses and claims so we could manually enter the case information into our database.
We removed cases with out-of-state defendants or out-of-state plaintiffs and any cases in which missing records made it difficult to confirm information about the provider.
