In Kansas City, hundreds of people are ending up in court over unpaid medical bills each year, and the issue is getting worse. 

But the bulk of the lawsuits are coming from only a couple of hospitals.

In a survey of the area’s acute care hospitals, The Beacon found that The University of Kansas Health System and NKC Health have brought more than 400 lawsuits against patients in debt in Missouri and Kansas so far this year.

Of the hospitals looked at, the two institutions are also alone in garnishing patients’ wages to recoup payment. And NKC Health seems to be the only one that places liens on patients’ property to get payment, although the hospital said the practice is rare.

Other area hospitals don’t use those same tactics.

In published financial assistance policies, St. Luke’s Health System and AdventHealth disclose that they send unpaid bills to outside collection agencies. Spokespeople for the institutions said those agencies do not sue on the hospitals’ behalf, garnish wages or place liens on property.

St. Luke’s and AdventHealth declined interview requests about what approaches they take instead to recoup debt.

HCA Healthcare, one of the country’s largest for-profit hospital chains, no longer sues its patients over unpaid bills. The chain owns five Kansas City-area hospitals, including Research Medical Center.

For-profit Prime Healthcare, which owns St. Mary’s, St. Joseph and Providence medical centers, did not respond to requests for information about debt collection practices. No obvious recent debt collection lawsuits could be found in court records.

The approach hospitals take to debt collection varies widely because, for the most part, every medical practice or hospital can establish its own policies. There is no legislated standard.

What’s happening at NKC and KU

NKC Health, the area’s only independent hospital, has filed 92 debt collection lawsuits in Missouri courts so far in 2026, according to a cursory count of cases in the state’s court database. 

A search for the University of Kansas Hospital turns up around 218 medical debt cases filed this year in Missouri and 114 in Kansas, according to the state’s court database. Those counts are, at best, rough estimates.

In a written response to questions, NKC Health Chief Financial Officer Austin Jones explained that the hospital’s use of “extraordinary collection activities,” such as garnishing wages or placing liens against patients’ assets, is “rare,” but a spokeswoman couldn’t provide specific numbers. She said those measures are “likely less than 0.01%.”

Both NKC and KU said they work to identify patients who qualify for financial assistance before going to court, something required by law. And both hospitals offer discounts and interest-free payment plans when patients qualify. They also said they try to help patients find insurance coverage, including Medicaid. 

Colette Lasack, who oversees billing for the KU Health System, said going to court is always the last resort. 

“If there’s anything we can glean from our data that tells us this patient might qualify for charity,” she said, “we want to act on that.”

Required to help patients who need it

Providing financial assistance for emergency and “medically necessary” care to patients who need it is not just an option, but a federal legal requirement for nonprofit hospitals like NKC Health and KU Health System, which receive tax-free status. 

In fiscal year 2025, the KU Health System wrote off $150.5 million in patient charges as charity care, down from $155.3 million in 2024, according to a bond statement issued in April. The health system reported operating revenue of $5.4 billion for the year, with operating income of $120 million.

NKC Health, which had net patient service revenue in 2025 of $788 million, reported providing just over $20 million in charity care in 2025, compared to $12.5 million the previous year. The hospital calculates charity care as the sum charges it did not collect due to discounts offered, plus expenses related to that care. The hospital also wrote off just under $45 million in uncollectible accounts in 2025, and roughly $43 million in 2024, according to its tax filing.

Lasack at KU Health System said she wants patients to know that reaching out to the hospital is always a better approach than ignoring bills, messages and phone calls.

“The message for patients is, pick up the phone and call us,” she said. “Let us know what’s going on because we’re here to help.”

To learn more about how medical debt is devastating an increasing number of Kansas Citians, dig into this story.