Nationwide-Hospital Lawsuits for Overcharging

 American patients have little control over the hospital bills they receive after consenting to ambiguous admission forms before surgery. This article examines lawsuits against a plethora of hospitals across the country, for overcharging patients and insurance companies for services. And it’s not just the unfortunate folks without insurance who are being charged the inflated chargemaster prices, but fully insured people are also getting ripped off. The chargemaster is a list of prices that each hospital develops as a negotiating point with the Centers for Medicare and Medicaid and private insurers and is not based on actual reimbursements. 

Location	Hospital	Basis of the Lawsuit
California	Sutter Health, a nonprofit entity	575 million-settlement with the Attorney General of CA for overcharging (Office of the Attorney General California, 2021)
Colorado	St. Anthony North Hospital, a nonprofit entity	Patient sues under reasonableness clause for nonnetwork charges & hospital failure to disclose true cost before admission (Levenson, 2022)
Florida	North Okaloosa Medical Center, a nonprofit entity and 19 others	A 2015 review of the 50 hospitals which overcharged the uninsured the most reveals 20 sited in Florida (Post, 2015)
New York	Foundling Hospital, a nonprofit entity	Attorney General has prevailed in many lawsuits against hospitals, but the most egregious may be the 250 million settlement by Foundling Hospital for overbilling Medicaid (New York State Office of the Attorney General Press Release Archives, 2014)
North Carolina	Vidant Health, a nonprofit entity	Patient sues for being overcharged for common imaging procedures (Paavola, 2022)
Ohio	One of the state’s largest hospital groups, so either Ohio Health Corp or the Cleveland Clinic, both nonprofit entities	Supreme Court is hearing a suit brought by uninsured patients contesting the “reasonableness” clause in common-law for hospital charges (The Eisen Law Firm Co. L.P.A.)
Tennessee	Team Health, a nonprofit entity Mission Hospital-HCA, a for profit entity	Team Health sued by United Healthcare for overcharging-100 million (Healthcare Finance News.com, 2021) Mission Hospital-HCA sued for monopoly power & reduction in services
Washington	St. Mary’s, Providence Health, a nonprofit entity	Sued by WA Attorney General for unnecessary procedures which resulted in overcharging and a 22 million settlement (New York Times, Seattle Times, Walla Walla Union-Bulletin)

 Since 2004, dozens of lawsuits have been filed on behalf of patients contesting the reasonableness clause and hospitals overcharging patients, especially the uninsured, so the Supreme Court of Ohio’s reasonableness ruling will be keenly watched by consumer groups. Don’t expect hospitals to lower their price gouging charges though, the behemoth hospital corporations will just rejigger their formulas so that we pay for their legal settlements. And so it goes, as the American public continues to be abused by its pay-to-play healthcare system instead of adopting much less expensive national healthcare programs like the rest of industrialized countries.

 And this is the healthpolicymaven signing off encouraging you not to sign blanket releases when you consent to procedures, do stipulate that for which you agree and what you decline.

 Roberta Winter is an independent healthcare analyst and journalist who accepts no money from any sector of US healthcare. This monthly column has been in continuous publication since 2007. In 2013 her guidebook to the US healthcare system was published by Rowman and Littlefield and an entire chapter was devoted to the price gouging of hospitals for the uninsured. https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972

 References

Healthcare Finance News.com. (2021, October 29). UnitedHealth sues TeamHealth, saying it overpaid $100 million in claims. (S. Morse, Ed.) Healthcare Finance News.com. Retrieved May 22, 2022, from https://www.healthcarefinancenews.com/news/unitedhealth-sues-teamhealth-saying-it-overpaid-100-million-claims

Levenson, M. (2022, May 21). She Was Told Surgery Would Be About $1,300 Then The Bill Came: $229,000. The New YorkTimes. Retrieved May 22, 2022, from https://www.nytimes.com/2022/05/21/us/colorado-hospital-lisa-french.html

New York State Office of the Attorney General Press Release Archives. (2014, February 5). Retrieved from https://ag.ny.gov/press-release/2014/ag-schneiderman-announces-250k-settlement-ny-foundling-hospital-overbilling

Office of the Attorney General California. (2021, August 27). Attorney General Bonta Announces Final Approval of $575 Million Settlement with Sutter Health Resolving Allegations of Anti-Competitive Practices. Office of the Attorney General Press Release. Retrieved May 22, 2022, from https://oag.ca.gov/news/press-releases/attorney-general-bonta-announces-final-approval-575-million-settlement-sutter#:~:text=The%20settlement%20requires%20Sutter%20to,%2C%E2%80%9D%20said%20Attorney%20General%20Bonta.

Paavola, A. (2022). Patients Are Coming After Hospital Prices. Becker Hospital Review. Retrieved May 22, 2022, from https://www.beckershospitalreview.com/legal-regulatory-issues/patients-are-coming-after-hospital-prices.html

Post, L. (2015, June 8). 50 hospitals charge uninsured more than 10 times cost of care, study finds. The Washington Post. Retrieved May 22, 2022, from https://www.washingtonpost.com/national/health-science/why-some-hospitals-can-get-away-with-price-gouging-patients-study-finds/2015/06/08/b7f5118c-0aeb-11e5-9e39-0db921c47b93_story.html

The Austin Trial Lawyer.com. (2015, April). The Austin Trial Lawyer.com. Retrieved from The Austin Trial Lawyer.com: https://www.theaustintriallawyer.com/2015/04/in-federal-case-insurance-company-sues-texas-hospital-for-tortious-interference/

The Eisen Law Firm Co. L.P.A. (n.d.). Lawsuit Alleges Hospitals Overchared Uninsured Patients. Retrieved May 22, 2022, from https://www.malpracticeohio.com/lawsuit-alleges-hospitals-overcharged-uninsured-patients-part-1/

Yates, D. (2016, June 22). Federal judge rejects Aetna’s $225M fraud claim, finds for North Cypress. Retrieved from https://setexasrecord.com/stories/510933779-federal-judge-rejects-aetna-s-225m-fraud-claim-finds-for-north-cypress