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Home›Schemas›Court: the patient does not have to pay a gigantic surprise bill

Court: the patient does not have to pay a gigantic surprise bill

By Warren B. Obrien
May 20, 2022
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The Colorado Supreme Court ruling said internal hospital charge officer rates “became increasingly arbitrary and, over time, lost any direct connection to actual hospital costs, instead reflecting inflated tariffs set to produce a targeted amount of profit for hospitals”.

Newsweek: Woman charged with $303,709 for $1,337 surgery wins court battle over bill

A woman who was billed $303,709 for surgery she expected to pay $1,337 in 2014 has taken a major step towards clearing that debt after the Colorado Supreme Court ruled in his favor. According to the Denver Post, St. Anthony North Health Campus Hospital had let French know that a pair of back surgeries she needed would cost her $1,337 out of pocket, with her health insurer paying the rest. the bill. (Beresford, 5/19)

The Washington Post: Lisa French, billed more than $300,000 by Colorado hospital for back surgery, wins state Supreme Court case

As part of forms she filled out at the nonprofit hospital in Westminster, Colorado, operated by Centura Health, [Lisa] French, unknowingly, had pledged to pay all fees associated with the hospital’s then-secret “chargemaster” price rates—a master price list that determined the posted prices for everything the hospital did. Years after French argued she was never told about the chargemaster and embroiled in a years-long legal battle with the hospital, the Colorado Supreme Court ruled in her favor this week, saying that she was not required to pay the rest of the huge bill because she did not agree to the hospital’s secret tariff scheme. (Bella, 05/19)

AP: Court issues $300,000 hospital bill for promised $1,300 tab

Judge Richard Gabriel, writing for the court, further asserted that the internal tariffs of hospital charging officers “have become increasingly arbitrary and, over time, have lost any direct link to actual hospital costs.” , instead reflecting inflated rates set to produce a targeted amount of profit for hospitals after factoring in discounts negotiated with private and government insurers. The drawn-out case first went to a civil lawsuit, which found that French only owed Centura Health an additional $767. An appeals court later ruled in favor of Centura, finding that hospitals could not predict the exact costs of care in advance and that the term “all charges” included in the contract required French to pay the total amount billed to him. (5/19)

As well –

Colorado Sun: Colorado hospitals among best for privately insured prices: study

Colorado hospitals in 2020 charged privately insured patients on average nearly three times what Medicare paid for the same services, according to a new report released this week. The report, by researchers at Rand Corp., a nonpartisan think tank, ranked Colorado 12th in the nation for the gap between Medicare and privately insured. Nationally, hospitals charged privately insured patients an average of 224% of what Medicare pays for the same services. (Ingold, 05/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage by major news outlets. Sign up for an email subscription.

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