Jury Sides With Patient in Hospital Bill Lawsuit

A Colorado woman has won a decision against a hospital that sued her for an unpaid bill. A jury has determined that the remaining $229,112.13 bill was excessive and awarded the hospital $766.74.

In June 2014, Lisa French underwent a spinal-fusion surgery at St. Anthony North Health Campus, north of Denver, Colorado. Prior to her surgery, Centura Health provided an estimate of patient responsibility of $1,336.90. The hospital bill ultimately totaled $303,709.49.

ELAP Services, the firm that advised French’s insurer, audited the fees and advised the insurer to pay a reduced amount. The insurer and French paid the hospital a total of $74,597.35. St. Anthony’s parent company, Centura Health Corporation, sued French for the remaining $229,112.13.

Following a six-day trial, a jury awarded the hospital $766.74.

Wendy Forbes, a spokesperson for Centura Health, said, “The evidence presented at trial was that St. Anthony North’s charges are among the lowest in the community for services received by Lisa French…She had a very complicated surgery with major complications due to her personal, pre-existing health conditions. The charges were fair and reasonable and grounded in the fundamental economics of health care under our current system.” Centura Health plans to appeal the verdict.

French’s attorney, Ted Lavender, from FisherBroyles’ Atlanta office, commented to OTW, “Each hospital sets its own chargemaster rates. Hospitals also have the burden of proving their chargemaster rates are reasonable when they sue patients to collect additional money. Most regular citizens do not have the knowledge or understanding of hospital chargemasters to see the irrational and unreasonable prices they contain. This verdict shows what happens when citizens are educated about those issues.”

Lavender said, “I do think this verdict is indicative of the broken hospital billing system that exists nationally, the basis of which is rooted in hospital chargemaster rates that bear absolutely no rational relationship to the value of the hospital goods and services being provided.”

ELAP co-founder and CEO Steve Kelly stated, “We believe the jury decision shows our payments are fair to healthcare providers and reflect the values of the communities where our members live.”