A Minnesota hospital company that worked with debt-collection firm Accretive Health is in hot water with the federal government over allegedly harassing sick patients for money in the emergency department and at their bedsides.

The University of Minnesota Medical Center in Minneapolis, a Fairview Health Services hospital, could get booted from Medicare and Medicaid as a consequence of these alleged activities, according to the Star Tribune. Lesser sanctions are more likely, however, the newspaper reports.

Fairview Health Services, a nonprofit hospital chain, and Accretive Health have been under intense scrutiny since April, when Minnesota Attorney General Lori Swanson issued a six-volume report accusing the companies' employees of harsh tactics including demanding payments upfront from emergency room patients and pressing bedridden patients for money.

Patients were led to believe they would be denied medical care if they didn't pay in advance or settle previous debts, Swanson's reports says. A probe by the federal Centers for Medicare and Medicaid Services uncovered similar incidents, including a woman seeking treatment for a possible heart attack who was asked for $672, according to the Star Tribune.

Federal inspection documents obtained by the Star Tribune show that the hospital repeatedly violated government rules by subjecting patients and their relatives to "abuse and harassment" during bill-collection attempts in the emergency room, labor and delivery area and other wards.

Documents obtained by the Star Tribune show patients' rights against harassment were violated and that the hospital broke a federal law forbidding poor patients from being refused treatment if they can't pay, the newspaper reported. "We are very concerned about the issues that came up and are working collaboratively with CMS to get them resolved," University of Minnesota Medical Center President Carolyn Wilson said in a written statement to the Star Tribune.

Swanson's reports and media accounts by the New York Times and other outlets sparked outrage among Democratic politicians including Minnesota Sen. Al Franken, led to new federal regulations restricting medical debt collection, and pushed the American Hospital Association to update its guidelines for billing and debt collection. A month after Swanson published her reports, Fairview CEO Mark Eustis announced he would step down.

Fairview Health Services, North Memorial Health Care and Maple Grove Hospital, which is jointly run by those two companies, outsourced billing, debt-collection, and other services to Accretive Health.

Accretive Health agreed to leave Minnesota for as long as six years and up $2.5 million in order to settle a lawsuit Swanson filed. The company continues to deny Swanson's charges that patients were strong-armed by Accretive Health employees or hospital workers operating under Accretive Health's policies.

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  • 10. France

    Total expenditure on health per capita: $3,978 Expenditure as % of GDP: 11.8% (3rd most) Annual growth of total health expenditure: +2.7% (18th most) Life expectancy: 81.5 years (8th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 9. Germany

    Total expenditure on health per capita: $4,218 Expenditure as % of GDP: 11.6% (4th most) Annual growth of total health expenditure: +4% (15th most) Life expectancy: 80.3 years (18th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 8. Austria

    Total expenditure on health per capita: $4,298 Expenditure as % of GDP: 11% (8th most) Annual growth of total health expenditure: +2.2% Life expectancy: 80.4 years (16th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 7. Denmark

    Total expenditure on health per capita: $4,348 Expenditure as % of GDP: 11.5% (6th most) Annual growth of total health expenditure: +6% (11th most) Life expectancy: 79.0 years (25th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 6. Canada

    Total expenditure on health per capita: $4,478 Expenditure as % of GDP: 11.3% (7th most) Annual growth of total health expenditure: +7.4% (7th most) Life expectancy: 80.7 years (tied for 12th highest)

  • 5. Luxembourg

    Total expenditure on health per capita: $4,808 Expenditure as % of GDP: 7.8% (7th least) Annual growth of total health expenditure: +8% (6th most) Life expectancy: 80.7 years (tied for 12th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 4. Netherlands

    Total expenditure on health per capita: $4,914 Expenditure as % of GDP: 12% (2nd most) Annual growth of total health expenditure: +16.4% (the most) Life expectancy: 80.6 years (14th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 3. Switzerland

    Total expenditure on health per capita: $5,344 Expenditure as % of GDP: 11.6% (5th most) Annual growth of total health expenditure: +2.8% (17th most) Life expectancy: 82.3 years (2nd highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 2. Norway

    Total expenditure on health per capita: $5,352 Expenditure as % of GDP: 9.6% (16th most) Annual growth of total health expenditure: +8.4% (4th most) Life expectancy: 81.0 years (10th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>

  • 1. United States

    Total expenditure on health per capita: $7,960 Expenditure as % of GDP: 17.4% (the most) Annual growth of total health expenditure: +2.2% (14th least) Life expectancy: 78.2 years (27th highest) Source: <a href="http://247wallst.com/2012/03/29/countries-that-spend-the-most-on-health-care/#ixzz1qWtpJfhZ" target="_hplink">24/7 Wall St. </a>