Patients in Hampton Roads have previously told WHRO they’re often left in the dark when it comes to medical bills, with missing details, unexpected charges and little clarity on what they owe.
Some said they never received itemized bills. Others said their accounts were sent to collections while they were still disputing charges.
Now, a new report suggests those experiences are part of a broader system — one that can lead to lawsuits, wage garnishment and long-term financial strain for patients across Virginia.
Researchers at Stanford and George Washington universities found hospitals and medical providers filed 1.15 million lawsuits against patients to collect over $1.4 billion in medical debt between 2010 and 2024.
More than 400,000 of those cases led to wage or bank account garnishment.
Over 15 years, Virginia Beach recorded 68,166 medical warrants in debt suits, a legal filing used to seek repayment of a debt, ranking third in the state.
Chesapeake had 45,521 cases, ranking ninth highest in Virginia.
“We're finding is these aggressive, egregious practices, is a whole ecosystem against the American worker, where their wages and their paycheck are garnished to pay off the hospital when the hospital didn't have to prove that they were overcharged or charged appropriately,” said Cynthia Fisher, founder of PatientRightsAdvocate.org, a nonprofit pushing for health care price transparency and one of the report authors.
Fisher described the process as a “medical debt ecosystem” involving hospitals, law firms and courts.
She said the system often begins before a bill is ever issued. Patients receive care without knowing the price, then are billed weeks or months later. If the balance goes unpaid, or is disputed, accounts can be sent to collections. Sometimes that can add fees or interest, and in some cases, they escalate into lawsuits.
The issue has drawn national attention before. A 2021 study found health systems at the University of Virginia and Virginia Commonwealth University had filed more lawsuits against patients over unpaid bills than any other medical groups in the country.
Between January 2018 and July 2020, VCU filed 17,806 court actions against patients — the most of any institution reviewed. UVA’s medical center ranked second, with 7,107 cases.
Danielle Pierce, director of public relations of VCU health, said the system is evaluating the data in the report from Stanford and George Washington universities, while raising concerns about its data accuracy.
“We have significant concerns regarding the accuracy of these claims and are thoroughly examining our records,” Pierce said in a statement sent to WHRO.
UVA Health said it has since changed its policies. Spokesperson Eric Swensen said it has not filed lawsuits against patients for unpaid medical bills since 2019 and has expanded financial assistance, including eliminating liens and discounts for lower-income patients.
“Our goal is to not need to use the collections process and instead work with our patients to provide financial assistance for those who qualify and offer fair payment options for all patients,” said Swensen in a statement sent to WHRO.
Though federal law requires hospitals to post their prices online, Fisher said the information is often difficult for patients to find or understand in practice.
“When you go to the grocery store, you don't expect to pay 10 times more for a gallon of milk than what you knew was priced on the shelf,” Fisher said. “But in healthcare, we do pay over 10 times more for an aspirin because we can't see the prices.”
She said bills can also be “up-coded,” or listed as a higher-level service than what the provider actually performed.
Fisher and her organization are pushing for stronger enforcement of pricing laws and building tools to help patients compare costs before care.
