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The Baltimore Sun discovered that unbeknownst to state regulators and legislators, non-profit hospitals were suing tens of thousands of patients in local courts over unpaid bills even though those bills were covered through the rate-setting system. Some of the hospitals that filed the most lawsuits were also collecting consistent surpluses on unpaid and charity care through the rate-setting formula, something that the rate-setting commission could not explain. Patients were often railroaded through the legal system. And hospitals violated state laws or contracts with insurance companies by suing patients for amounts they were not permitted to collect.