Eamon Queeney/KFF Health News
Bridget Narsh’s son, Mason, needed urgent help in January 2020, so she was offered the chance to send him to Central Regional Hospital, a state-run mental health facility in Butner, North Carolina.
The teen, who deals with autism and post-traumatic stress and attention-deficit/hyperactivity disorders, had started destroying furniture and running away from home. His mother worried for the safety of Mason and the rest of the family.
But children in crisis in North Carolina can wait weeks or months for a psychiatric bed because the state lacks the services to meet demand. And when spots do become available, they are expensive.
The standard rate at Central Regional was $1,338 a day, which Narsh could not afford. So, when a patient relations representative offered a discounted rate of less than $60 a day, her husband, Nathan, signed an agreement.
Mason, now 17, was hospitalized for more than 100 days in Central Regional over two separate stays that year, documents show.
But when requests for payment arrived the following year, Narsh said she was shocked. The letters — which were marked “final notice” and requested immediate payment — were signed by a paralegal in the office of Josh Stein, North Carolina’s attorney general. The total bill, $101,546.49, was significantly more than the roughly $6,700 the Narshes expected to pay under their agreement with the hospital.
“I had to tell myself to keep my cool,” says Bridget Narsh, 44, who lives with her husband and three children in Chapel Hill. “There is no way I could pay for this.”
Medical bills have upended the lives of millions of Americans, with hospitals putting liens on homes and pushing many people into bankruptcy. In recent years, lawmakers have railed against privately operated hospitals, and states have passed laws intended to make medical billing more transparent and limit aggressive debt collection tactics.
Some state attorneys general — as their states’ top law enforcement officials — have pursued efforts to shield residents from harmful billing and debt collection practices. But in the name of protecting taxpayer resources, their offices are also often responsible for collecting unpaid debts for state-run facilities, which can put them in a contradictive position.
“I have real concerns about this