The practice of one individual or organization selling its accounts receivable (unpaid bills) to a second at a discount. The latter organization, called the ‘factor,’ usually, but not always, assumes full risk of loss if the accounts prove uncollectible. In health services delivery, the expression generally refers to a hospital’s or physician’s sale of unpaid bills to a collection agent. Factoring has sometimes been used in Medicaid because of the delays that hospitals and physicians experience collecting from the State Medicaid agency. In these cases, the improved cash flow is worth the discount in the amount received by the provider. Because factoring is subject to fraud and abuse, Congress has sought to prohibit some of its uses.