The Office of Washington Attorney General Bob Ferguson won a trial against debt collection agency Optimum Outcomes on March 20, 2024. This was the final case in an ongoing charity care lawsuit by the Office against Providence Health & Services, one of the nation’s largest health care systems, and its debt collectors.

King County Superior Court Judge Sean O’Donnell ruled that Optimum violated Washington’s Consume Protection Act by withholding debt collection rights disclosures in nearly 83,000 collection notices. This included the right to apply for financial aid. Judge O’Donnell ordered a $10 penalty per violation, for a total of $827,290. The Attorney General’s Office will also be reimbursed for its costs in bringing the case, estimated at over $400,000.

The court held that Optimum unlawfully collected payment without providing information about medical debt rights, finding that patients who were likely eligible for financial assistance were barred from learning about their options and were instead sent to collections.

Characterizing it as the “largest charity care lawsuit in American history,” AG Ferguson first filed the lawsuit against Providence in February, 2022. He alleged that 14 different hospitals and two debt collectors engaged in practices that kept patients from accessing financial aid. The Providence settlements have totaled over $160 million in refunds and debt forgiveness for patients.