Law Street Media

Hospital System Sued by Patient for Alleged Billing Scheme

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In a putative class action filed Friday in North Carolina federal court against Vidant Health and related entities, plaintiff George Cansler alleged that the company violated North Carolina’s unfair practices and debt collection laws.

The class action complaint includes alleged violations of the North Carolina Unfair and Deceptive Trade Practices Act (UDTPA), the Declaratory Judgment Act, the Fair Debt Collection Practices Act (FDCPA), and the North Carolina Collection Agency Act (NCCAA). Cansler alleges that the defendants have “used and continue to use an unfair, deceptive scheme designed to extract undisclosed and unreasonably high prices from patients.”

Defendant Vidant Health is a “not-for-profit, 1,447-bed hospital system,” which functions as one of the largest health systems in North Carolina. When billing patients like the plaintiff for medical services, Vidant does not disclose the price of a service prior to the service, the complaint says. Instead, patients discover the cost of care after receiving the services. The complaint explains that this practice by Vidant “made it impossible for patients to make an informed financial decision about their care.”

The complaint argues that Vidant consistently charges unreasonably high prices, and in the case of many common procedures, Vidant “charges patients more than 10 times the rate that Medicare would pay for that identical service.” In addition to failing to disclose pricing prior to billing and charging unreasonable prices, Vidant “coerces patients into paying their excessive prices by threatening to send them to collections, report them to credit reporting agencies, damaging their credit scores, and imposition of interest and legal fees.” The short payment deadlines imposed by Vidant are affected by common occurences as simple as mail delays. If the bill is not paid according to Vidant’s timeline, patients then begin to receive threats from Vidant’s debt collector, FirstPoint.

The plaintiff received services at one of Vidant’s hospitals while he had an insurance policy with Blue Cross. Despite Blue Cross’s negotiations with Vidant regarding the allowed amounts for procedures, the allowed amounts remained “unreasonably high.” Cansler had signed an agreement titled “Authorization & Consent for Treatment and Assignment of Benefits,” in which he agreed to be financially responsible for “charges.” However, he asserts that the term “charges” is not well-defined and that the patients “have not agreed to pay the inflated chargemaster or allowed amounts,” and that they owe only the reasonable cost for the service.

After receiving services, Cansler said he has communicated with his insurance company and Vidant, questioning how the amount owed was so high. Following this back-and-forth, Vidant Health sent Cansler a “final notice” dated July 29, 2019. He received the letter on August 14, 2019. However, the letter asserted that his account “may be referred to an outside collection/credit reporting agency if full payment or satisfactory arrangements are not made within 10 days of the date of this letter.” The plaintiff did not even receive the letter until 17 days after it was dated, yet was already being threatened by Vidant’s debt collector, FirstPoint.

The plaintiff explains that his experience was typical of patients who received care from Vidant, and that due to its position as a “regional monopolist, residents of Eastern North Carolina have no choice but to submit to its unreasonable charges and aggressive collection efforts.”

The complaint cites declaratory and injunctive relief and violations of the North Carolina Unfair and Deceptive Trade Practices Act (UDTPA), the Declaratory Judgment Act, the Fair Debt Collection Practices Act (FDCPA), and the North Carolina Collection Agency Act (NCCAA). Cansler is seeking class certification for all individuals similarly situated, favorable judgment on all counts, appropriate declaratory and injunctive relief, compensatory, actual, statutory, and treble damages, litigation fees, and any other relief deemed proper by the court.

The plaintiff is represented by Wallace & Graham.

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