October 17, 2014

Hospitals and HCA charged with exorbitant and unlawful billing of auto accident patients

Memorial Hospital Jacksonville and North Florida Regional Medical Center, Inc., of Gainesville, Fla., along with JFK Medical Center and parent company HCA, Inc., have been charged with violations of Florida’s Deceptive and Unfair Practices Act in an amended class action complaint filed in a federal court this week.

Two Florida residents, Nicholas Acosta and Penny Wollmen, have joined Marisela Herrera and Luz Sanchez as named plaintiffs in the amended class action lawsuit, which was filed Oct. 15, 2014, in U.S. District Court Middle District of Florida, Tampa Division. The complaint challenges the Florida medical centers and HCA, their Nashville, Tenn., based parent company, with billing exorbitant and unreasonable fees for emergency radiological services covered in part by the plaintiffs’ Florida Personal Injury Protection (PIP) insurance. 
 
Under Florida’s No Fault Car Insurance Law, drivers are required to have $10,000 in PIP insurance.

“In many cases the rates charged PIP-covered patients were up to 65 times higher than the hospitals’ usual and customary charges and or payments for similar radiological services to non-PIP patients,” said plaintiffs’ lead attorney Theodore J. Leopold of Cohen Milstein Sellers & Toll PLLC. “Patients who show up at the emergency room following a motor vehicle accident not only have to pay their 20 percent co-pay, but then are billed far more for their tests, which clearly violates the PIP law that requires ‘customary and reasonable’ pricing.”

First filed in U.S. District Court, Southern District of Florida, in July 2014, the lawsuit was brought by Marisela Herrera and Luz Sanchez, both of whom were PIP-covered patients who were treated through JFK Medical Center’s emergency department after their automobile accidents in April 2013 and May 2013, respectively. Herrera and Sanchez each received a CT of the brain for $6,404, a CT scan of the spine for $5,900, and a thoracic spine X-ray for $2,222. Herrera also received a lumbar spine X-ray for $3,359. 

Plaintiffs Nicholas Acosta and Penny Wollmen had similar experiences. Following an Oct. 11, 2013, automobile accident, Acosta received treatment in the emergency department of Memorial Hospital Jacksonville. There he was charged $6,965 for a CT scan of his spine, and $6,277 for a CT scan of his brain. Wollmen, who was treated at North Florida Regional Medical Center following a Feb. 5, 2014, auto accident, was charged $6,853 for the CT scan of her cervical spine, $6,140 for the CT scan of her brain, and $1,454 for the X-ray of her thoracic spine.

The complaint charges that because of the exorbitant rates, each of the plaintiff’s $10,000 PIP coverage was prematurely exhausted and all four were billed thousands of dollars for radiological services not paid for by their PIP insurers.  In terms of radiological services alone, Herrera has been billed more than $6,500, Sanchez has been billed more than $2,500, and Acosta has been billed more than $13,000. Wollmen has been paying out-of-pocket for other medical services, such as regular chiropractic care that would have been covered in full or in part by her PIP insurance had it not been exhausted.

The complaint also charges breach of contract since all four plaintiffs entered into a “Condition of Admission” contract that provides that patients must pay their accounts at the rates stated in the hospital’s price list.  None of the plaintiffs were provided a price list at the time of medical treatment.

In addition to Cohen Milstein Sellers & Toll PLLC, the plaintiffs are represented by Boldt Law Firm, of Hollywood, Fla., and Gonzalez & Cartwright, P.A., of Lake Worth, Fla. For more information about the lawsuit, visit Herrera and Sanchez et al v. JFK Medical Center Limited Partnership and HCA, Inc.,/case-study/hca.