Until this summer, Mississippi lawyer Richard Scruggs was best known as the maverick who brought Big Tobacco and asbestos industries to their knees through aggressive class action lawsuits. Scruggs has a new target this year: not-for-profit hospitals and their billing and collections practices for uninsured patients. Scruggs leads an impressive array of lawsuits launched by uninsured patients against 400 not for profit hospitals and health systems nationwide—and he has named the AHA as a codefendant.

The argument behind the lawsuits contains 4 elements:

1. Hospitals’ aggressive collections tactics against the uninsured violate their tax exempt status as charities.
2. Hospitals routinely charge uninsured patients higher rates than insured patients for the same procedures.
3. Not-for-profit hospitals violate tax laws by allowing for-profit businesses like doctors’ groups and outsourced services to operate under subsidies from the hospital.
4. Hospital billing and collection policies and practices are affecting access to care.