Sen. Roger Marshall's former medical practice sued more than 700 patients over unpaid medical bills, with court records showing arrests in 81 of those cases after patients missed court dates, according to a New York Times investigation. The cases involved medical debts ranging from $101 to several thousand dollars and included an 18% annual interest rate on unpaid bills.
The New York Times reported on September 8 that Marshall sued more than 700 patients over outstanding medical bills during his decades-long career as an OB-GYN. The newspaper reviewed thousands of pages of Kansas court records and interviewed eight people who had been sued by Marshall.
In another 13 cases, Marshall's lawyers sought arrest warrants, but the records did not establish whether an arrest occurred.
The lawsuits involved bills ranging from several thousand dollars to as little as $101. The cases also included wage and bank-account garnishments. Patients were routinely charged an annual interest rate of 18% on unpaid bills, according to the investigation.
About half of the lawsuits were filed under Marshall's name. The others were filed under Heartland Regional OBGYN, the medical practice he solely owned from 1998 to 2012 and then co-owned with another physician from 2013 to 2019.
Many of the patients lived in Barton County, a rural area with above-average poverty and uninsured rates. Some patients did not have health insurance, while others had coverage but still owed part of their medical bills. Some lawsuits involved new mothers who had outstanding bills related to childbirth.
The New York Times interviewed eight people whom Marshall sued between 2003 and 2015. Most said they lived paycheck to paycheck and sometimes had to choose between paying medical bills and buying groceries. Two said the medical bills pursued in court followed late miscarriages that required surgery.
The arrests in the cases occurred after patients missed court appearances in debt-collection lawsuits.
Federal law prohibits traditional debtors' prisons, but some state laws allow arrests when defendants in debt lawsuits fail to appear in court.
Marshall's spokeswoman, Payton Fuller, told The New York Times that judges issue warrants when people repeatedly miss court dates, not doctors. Court records reviewed by the newspaper show that Marshall's lawyers repeatedly requested arrest warrants, including in the case of Joe Vasquez and his wife.
Steven Johnson, a lawyer who frequently represented Marshall in the debt cases, said Marshall was not involved in decisions about when to seek warrants, arrests or garnishments. Johnson said Marshall allowed his law firm to take the steps it considered necessary to pursue unpaid bills. He also said Marshall set the 18% interest rate contained in a contract signed by patients.
One case involved Joe Vasquez and his wife.
Marshall sued the couple over a $4,561 unpaid bill related to his wife's emergency hysterectomy. The procedure had taken place three years earlier. After the couple missed a court date, Marshall's lawyers sought an arrest warrant. Police arrested the couple during Easter weekend in 2007. They spent two days in jail before their son borrowed money to post bond, according to The New York Times.
Vasquez said he was on disability at the time and his wife worked at a manufacturing plant. He said the family did not have enough money to pay the bill.
Vasquez also said Marshall's office had offered a $250 monthly payment plan that the couple could not afford. Court records indicate that the couple received the lawsuit summons and court-date notice, although Vasquez said he did not remember receiving them.
The couple eventually worked with a law firm to place the debt and other obligations into a payment plan. In November 2015, Marshall's lawyers filed a letter releasing the judgment against them, eight years after the arrest.
Meischa Zimmerman was arrested three times over six years in connection with a medical debt from a cesarean delivery.
Her first arrest occurred in 2011, when she was eight months pregnant and at home with her two-year-old child. She was arrested again in 2013 and 2016. Each time, she posted a $200 bond that went toward the debt, according to receipts reviewed by The New York Times.
Zimmerman did not have insurance during the pregnancy in 2009. She had planned to apply for Medicaid, but went into labor the night before she was due to visit the local Medicaid office.
Five months after giving birth, she was sued by Marshall over a $3,596 medical bill. Zimmerman later agreed to pay $50 a month, although she said she could not always make the payments. With 18% annual interest added to the balance, she recalled being told that the debt had grown to more than $7,000.
Across the 81 cases in which arrests were recorded, the debts ranged from $114 to $4,683, according to court records
In some cases, efforts to collect the money continued for more than 10 years, including after Marshall entered Congress.
The court cases reviewed by The New York Times included medical bills connected to childbirth and complications during pregnancy. In one case, a patient was sued over a $520 charge for surgery to remove retained placenta after childbirth. Her lawyer argued that the procedure should have been covered by the original delivery payment. The case was later dismissed. Her lawyer argued that the procedure should have been included in the original payment for the delivery. The case was dismissed.
Another patient was sued in 2004 over a $1,200 bill for care related to herself and her twins, whom she said she had lost. She remained responsible for the bill, according to the report.
Healthcare providers have different approaches to collecting unpaid bills.
Barak Richman, co-director of the health law program at George Washington University, told The New York Times that doctors can choose whether to use debt collectors, file lawsuits or stop pursuing a debt when a patient appears unable to pay.
Richman said wage garnishments and patient arrests were on the extreme side of medical debt collection.
Stanford University economist Neale Mahoney told The New York Times that research he conducted in one state found lawsuits against patients in about 1.7% of hospital stays. He described the scale of the collection activity in the Marshall cases as an extreme example.
The Marshall case comes as medical debt litigation by physicians and other non-hospital providers has received increasing attention.
A 2026 investigation by KFF Health News and CT Mirror examined more than 16,000 healthcare-related debt cases filed in Connecticut courts from 2019 through 2024.
In Connecticut, doctors, dentists and other non-hospital providers made up more than 80% of healthcare debt collection cases filed against patients and families in 2024, according to the investigation.
That figure applies only to Connecticut. The investigation found a different pattern five years earlier, when hospital systems accounted for about three-quarters of health-related collection cases in the state's courts.
The cases could lead to wage garnishments, property liens, interest charges and court fees. Hospitals that operate as tax-exempt nonprofits are subject to federal rules covering financial assistance and certain collection practices. Those requirements generally do not apply in the same way to private medical groups.
Marshall practiced obstetrics for more than 25 years before entering politics in 2016. He stopped practicing medicine after winning a seat in Congress that year. However, The New York Times found that some collection activity related to his medical practice continued while he served in the House from 2017 to 2021.
Marshall and eight other doctors opened a four-bed surgical center in Great Bend in 1998. The facility later grew into a full-service hospital. Marshall served as the hospital's board chairman, and his family retained ownership until March 2017.
The hospital filed hundreds of lawsuits against patients while Marshall was an investor and board chairman. The New York Times found more than a dozen cases from the years he served in Congress, based on its review of Kansas court records and financial disclosures.
Marshall's spokeswoman said the hospital had provided millions of dollars in uncompensated care. She said its billing and outside collection practices were the same as those used by other businesses and hospitals in Kansas.
Marshall has also made healthcare costs and price transparency a focus of his Senate work. The bill would require hospitals, ambulatory surgery centers, imaging centers and clinical laboratories to report negotiated rates, costs and cash prices. It also calls for detailed itemized bills or an all-in price for bundled services.
The Senate Health, Education, Labor and Pensions Committee approved the bill in July 2026 with bipartisan support.
Marshall's spokeswoman said he spent decades treating patients regardless of their ability to pay and highlighted his practice's treatment of Medicaid patients.
Fuller also disputed any suggestion that Marshall personally ordered patient arrests, saying judges issue warrants when defendants repeatedly miss court dates.
Marshall is seeking re-election to the Senate this fall.
(Rh/MSM)