Vidant Health Excessive and Undisclosed Charges to Patients Class Action

Vidant Health (officially University Health Systems of Eastern Carolina, Inc.) is a not-for-profit group of nine hospitals and other facilities, with revenue that in 2017 was over a billion and a half dollars a year. The complaint for this class action alleges that Vidant refuses to tell patients about costs before they get care, then charges them unreasonably high prices, and finally harasses them to pay the exorbitant bills. It names Vidant hospitals and medical facilities and a debt collection company, FirstPoint Collection Resources, Inc., as defendants.

A class and a subclass have been proposed for this action:

• The Vidant Class is all individuals who (1) visited a Vidant emergency room, between February 18, 2018 and the present, (2) signed the “Authorization & Consent for Treatment and Assignment of Benefits” or a similar document, (3) received a CT scan or other services, and (4) were billed, or a guarantor was billed personally for Vidant’s chargemaster or negotiated rates.
• The FirstPoint Subclass is all members of the Vidant Class who were subjected to debt collection efforts within the last year, including receiving one or more collection letters from FirstPoint regarding their Vidant bill.

Consumers do not negotiate prices for medical care. The “allowed amounts” for services are negotiated between providers and insurance companies. Hospitals have a “chargemaster,” or list of billable items with the charges for each. If a consumer with commercial insurance receives a service, the insurance company pays some of the allowed amount; the consumer must pay the rest.

The complaint alleges that consumers with high-deductible plans must pay “the vast majority of the allowed amount for a particular procedure (e.g., 80%), until the deductible is met. Thus, for the first several thousand dollars of medical treatment a patient receives each year, the patient pays a significant majority of that cost.”

Patients do not know what they must pay before they use the facility’s services. The complaint alleges, “Vidant followed a corporate policy of not disclosing the allowed amount of its services to patients even if they asked.” Thus, the complaint claims, there is no agreement on prices for services between the hospital and the patient.

The complaint compares Medicare prices for services with Vidant’s charges, for example, for a CT scan, and finds that Vidant’s prices are multiples of Medicare’s. The complaint alleges, “For many other common procedures, Vidant charges patients more than 10 times the rate that Medicare would pay for the identical service.”

The complaint asserts, “Neither Vidant’s chargemasters nor the allowed amounts they negotiate with commercial health plans are reasonable rates…”

It further claims, “Under North Carolina law, where there is no contract specifying the rate to be charged for treatment, a hospital is entitled only to the reasonable value of the service it provides.”

Afterwards, the complaint alleges, “when patients were unable or unwilling to pay the inflated prices, [Vidant] sought to coerce them into payment by threatening their credit score and engaging in collection efforts.”

Article Type: Lawsuit
Topic: medical
Tags: Excessive Fees, FDCPA, Medical Billing, Unfair Business Practices