Minnesota Attorney General Lori Swanson broadened her lawsuit against Accretive Health Inc. on Tuesday, adding new allegations that the bill-collecting consultant harassed and deceived Minnesota hospital patients in violation of consumer protection and privacy laws.

The amended complaint, filed in U.S. District Court, widens the scope of a suit Swanson filed in January and supplements it with sworn statements from patients who said they encountered heavy-handed collection tactics at Fairview Health Services, where Accretive controlled revenue functions under a contract started in 2010.

Swanson first brought the practices to light in April in a series of written reports, then elaborated a month later at a hearing in St. Paul conducted by U.S. Sen. Al Franken. On Tuesday she tied her growing list of alleged patient harassment incidents into the original lawsuit, which was filed on grounds that Accretive violated federal patient privacy laws and state consumer protection and fair debt collection statutes.

Chicago-based Accretive said the new allegations contain "numerous mischaracterizations and distortions of documents and facts.'' The company said it plans to ask the court to dismiss the expanded complaint in its entirety. Accretive was dropped as Fairview's consultant shortly after Swanson's report in April.

The original suit began with an investigation into the theft of an unencrypted laptop computer from an Accretive employee, which contained sensitive information on 23,500 Minnesota patients of Fairview and North Memorial Health Care.

Accretive told the U.S. Senate that nine company laptops were stolen in 2011 alone and more than 30 of its laptops had not been properly encrypted -- a training failure that ranks as a violation of a federal patient privacy law known as HIPAA, the new complaint said.

At Franken's hearing, Swanson also alleged that Accretive and North Memorial had no Business Associate Agreement allowing Accretive access to patient information, a serious violation of HIPAA. The new complaint alleges the two parties concocted and backdated an agreement to avoid harsh sanctions -- a charge Accretive has denied and North Memorial has not commented on.

In the ER

Much of the revised complaint is devoted to stories of Fairview emergency room patients who believed they would not receive care unless they satisfied payment demands from bill collectors who confronted them on the spot.

Frank Przybilla, a part-time Ramsey County sheriff's deputy, said he was having a mini-stroke when a collector approached him and his wife in the emergency room of Fairview Riverside Hospital. Before he saw a doctor, the collector said, he needed to pay $350 "right then and there,'' the complaint said. Believing they wouldn't receive care unless they paid, the couple handed over a blank check.

"It felt like the woman didn't care if I was dying as long as she got the approximately $350 I owed for my treatment,'' Frank Przybilla said in one of 27 sworn statements added to the suit.

The federal Emergency Medical Treatment and Active Labor Act requires a hospital emergency room to treat patients in emergency situations regardless of their ability to pay. In addition, state law provides that no debt collector shall "imply or suggest that health care services will be withheld in an emergency situation."

Tony Kennedy 612-673-4213