Takeaways from probe into Roger Marshall's medical billing

Matthew Kelly, The Kansas City Star on Oct 12, 2026

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A Kansas City Star analysis found that as a rural Kansas doctor before voters sent him to Washington, U.S. Sen. Roger Marshall charged an unusually high interest rate on patients’ unpaid bills, compared to other Kansas physicians and medical practices.

Marshall, a Republican incumbent seeking reelection, has faced sharp criticism in the month since The New York Times revealed he sued more than 700 patients over unpaid bills ranging from several thousand dollars to as low as $101. Eighty-one former patients were arrested after failing to appear in court.

Marshall has dismissed the outrage as a political stunt and defended his debt collection practices, calling them “very common.”

Here are five takeaways from The Star’s investigation:

— Steven Johnson, a Great Bend lawyer who represented Marshall and his closely held OB-GYN practice in many of the lawsuits against patients, said Marshall’s office was responsible for setting the 18% annual interest rate on unpaid bills. Johnson said that if one of the creditors he represented had asked what the maximum interest rate was that they could charge on overdue bills, he would have advised them it was 18%.

— The analysis of medical debt lawsuits in the Kansas court system found that although it’s not uncommon for hospitals and clinics across the state to sue patients, the 18% annual interest rate Marshall applied to unpaid bills was by far the highest of the roughly 150 medical practices whose public records were reviewed by The Star. Active and defunct medical practices of all sizes across every region of the state were analyzed.

— In reviewing thousands of court documents, The Star found no other medical providers that charged annual interest at 18% or any other specified rate above 12%. Some attorneys questioned the legality of charging 18% interest, and most agreed that the higher rate would have to be disclosed in a contract to be legally enforceable.

— Marshall’s campaign provided no comment in response to phone calls, texts and emails seeking responses to a detailed list of questions over the course of two weeks for this story. One question the campaign declined to respond to is whether the 18% interest rate was first disclosed to patients up front or in an invoice after care had been provided.

— While his own business practices have been picked apart amid a hotly contested re-election campaign, Marshall has championed medical billing transparency legislation. Under the Patients Deserve Price Tags Act, which Marshall co-sponsored with Colorado Democrat John Hickenlooper, providers who refuse to furnish an itemized bill would face fines and be barred from turning patients over to debt collectors.

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