From The New York Times:
A Doctor Sued 700 Patients for Debts; 81 Were Arrested. Now He’s a Senator. Patients sued by Senator Roger Marshall of Kansas were routinely charged 18 percent interest, The Times found. Some had bank accounts garnished.
Senator Roger Marshall spent 25 years practicing obstetrics before running for Congress. Credit... Kenny Holston/The New York Times By Sarah Kliff
Sarah Kliff reviewed thousands of pages of court records and interviewed eight people whom Roger Marshall sued over medical debt.
Published Sept. 8, 2026 Updated Sept. 9, 2026, 4:46 p.m. ET It was Easter weekend in 2007 when a police car pulled up to Joe Vasquez’s home in rural Kansas. A doctor had filed a lawsuit against him and his wife over an unpaid $4,561 bill from her emergency hysterectomy three years earlier. They had missed a court date, and the doctor’s lawyers asked the court to issue an arrest warrant. The police took the couple into custody as their grandchildren prepared for an egg hunt, Mr. Vasquez said. They spent two days in jail before their son could borrow the money to post bond. “We had no money to pay,” said Mr. Vasquez, now 68. At the time, his wife was working at a manufacturing plant and he was on disability, he said. The doctor who sued the couple was Roger Marshall, now a senator from Kansas. Mr. Marshall, a Republican who is seeking re-election this fall, filed lawsuits against more than 700 patients with outstanding bills during his decades-long career as an obstetrician-gynecologist, according to a New York Times analysis of Kansas court records. Patients were arrested in 81 of those cases for missing court dates, the records show. In an additional 13 lawsuits, Mr. Marshall’s lawyers sought warrants but it is unclear whether an arrest occurred. They also garnished patients’ paychecks and bank accounts. They routinely charged patients an 18 percent annual interest rate. The unpaid bills ranged from several thousand dollars to as little as $101. About half the lawsuits were filed under Mr. Marshall’s name and the rest by Heartland Regional OBGYN, the medical practice he solely owned from 1998 to 2012 and then co-owned with another doctor from 2013 to 2019. Some facing lawsuits were new mothers with outstanding bills from their deliveries. Most lived in Barton County, a rural area with above-average uninsured and poverty rates. Some patients The Times spoke with lacked insurance; others had health coverage but were responsible for part of their bill. Joe Vasquez and his wife were arrested at an Easter party after missing a court date in their medical debt collection case. Credit... Clayton Steward for The New York Times “I had every intention to pay, I was just struggling,” said Kellie Clutts, whom Mr. Marshall sued in 2015 over a $129 bill. Ms. Clutts said the charge was from a postpartum visit shortly after her daughter’s birth. Mr. Marshall sued Ms. Clutts when her baby was 9 months old and eventually garnished her bank account. “I was recently divorced, trying to do everything on my own,” said Ms. Clutts, 45. “I told them I could make partial payments, but it seemed like no matter what I said, they wanted the full amount at once.” In response to detailed questions from The Times, a spokeswoman for Mr. Marshall said that he spent decades caring for patients regardless of their ability to pay. “Judges issue warrants when people repeatedly miss court dates, not doctors,” the spokeswoman, Payton Fuller, wrote in a statement. Court records show that Mr. Marshall’s lawyers repeatedly requested arrest warrants, including in Mr. Vasquez’s case. They filed dozens of briefs arguing that warrants were needed because of the defendant’s “refusal to obey Court orders.” Steven Johnson, a lawyer who often represented Mr. Marshall in debt cases, defended the warrants and ensuing arrests as necessary to ensure that debtors attended court dates. “If defendants were allowed to appear only when they wanted to without any consequences the court would get no business done,” he wrote in a text message. He said that Mr. Marshall was “no different” than his other clients in allowing his law firm to take the steps it felt were necessary to pursue an outstanding bill. As a client, Mr. Marshall was not involved in decisions about when to seek warrants, arrests or garnishments, Mr. Johnson said, but did set the 18 percent interest rate in a contract he had patients sign. Mr. Marshall’s office did not respond to a question from The Times about who set the interest rate. Doctors have wide discretion in how to handle unpaid bills. They can decide when to involve a debt collector, file lawsuits or drop the debt entirely if a patient seems unable to pay. “There is a lot of variation,” said Barak Richman, the co-director of the health law program at George Washington University who has studied medical debt litigation in three states . “There are a lot that do bring lawsuits but also a whole lot that don’t. It’s not because they’re in a different position, they’ve just decided they’re not going to do it.”
Some hospitals and doctors have increasingly relied on litigation as insurance deductibles have risen, leaving patients responsible for a great share of their bills.
Even so, wage garnishments and arrests of patients are “definitely on the extreme side,” Mr. Richman said.
Neale Mahoney, an economist at Stanford University, has conducted research in one state finding that lawsuits against patients are relatively rare, with about 1.7 percent of hospital stays resulting in litigation.
“It’s not surprising there are outliers but this does seem to be an extreme case,” in terms of how far a doctor went to pursue debt, Mr. Mahoney said.
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