RIP Medical Debt has reached a deal to buy $278 million in debt from Ballard Health, according to The Wall Street Journal. Many of those patients never should have been billed at all under the hospitals’s financial-aid policies, but seemingly failed to fill out the proper applications. Health care costs have soared recently, and bills are haunting patients.

Ballard owns many hospitals in Tennessee and Virginia, and some of the bills being bought out are over 10 years old. RIP Medical Debt says it will abolish the amounts owed and begin sending out notes to affected households this month. In some ZIP codes, as many as one in five households will be affected by the move.

RIP Medical Debt has relieved over $4.5 billion in medical debt since its founding in 2014 and helped more than 2.6 million families, the charity claims on its website. Sponsors donate funds, then the charity identifies households that are most in need of relief. It then buys that debt, typically at a steep discount, and forgives it.

Medical debt is a burden for millions of Americans of all economic levels. The Biden administration has identified it as an important enough issue that it has proposed striking medical debt from people’s credit reports, since the money owed is usually not a financial decision, but rather taken on in an emergency situation in which the sum isn’t known until the borrower has received care.

All totaled, Americans currently face $45 billion in medical debt in collections.