Kramer says that the litigation seeks to get refunds and outstanding account balances reduced for class members, i.e., people who were uninsured and billed outrageous emergency room charges. There has also been a recent favorable ruling on a similar class action in the general court of justice in the state of North Carolina, and there have also been other similar actions filed in South Carolina, Rhode Island, Pennsylvania and various other states as well. Basically, the class actions allege that uninsured emergency care patients are the victims of hospital overcharging.
How can emergency room patients be held hostage by a hospital?
Kramer explains that the problem stems from hospitals having patients sign an agreement, typically when they arrive at the emergency room under some sort of medical duress, which says nothing about the patient’s costs for treatment.
“An emergency room patient is typically given a consent agreement of some type which they are required to sign,” Kramer says. “This agreement not only provides consent for treatment, but typically contains a vague financial liability provision stating that the patient is responsible for the hospital’s charges. The problem is that the patients don’t see any list of these charges, and for the most part they are given no information whatsoever regarding charges or the fact that they will be charged far more than other patients for the same treatment. Nor does the patient have the ability to get pricing information or even find out what the charges will be based upon. In other words, the patient has no way of knowing or predicting that they will get a ridiculous and outrageous bill after discharge.”
For the uninsured, emergency room charges can run anywhere from three to 10 times more than the amount billed to other groups of patients. “These excessive charges are based on an artificially inflated pricing schedule that is literally not paid by anyone,” adds Kramer.
Hospitals like to point out that many uninsured people don’t pay anything on their bill, which often occurs because many patients, including those who may be homeless or in dire poverty, show up in ER as uninsured patients. But ER patients who have some assets or a good job can become caught in a system that is blatantly unfair, and emergency charges can end up ruining their credit rating and sometimes even their lives.
“Nobody finds out the cost of their ER visit until sometime after their discharge, when they get the bill in the mail,” says Kramer. “The problem is compounded because the government requires the ER to treat everyone regardless of their financial condition, but doesn’t require hospitals to explain their pricing methods, or let uninsured patients know they will be subject to rates that virtually nobody pays. Furthermore, a program that was established in order to help the uninsured by guaranteeing the availability to obtain emergency care fails to control the amounts that hospitals charge to uninsured patients.
“The hospital, in turn, uses these outrageous billed amounts as a basis to demand higher reimbursement rates from government health plans (i.e., Medicare and Medicaid) and insurance companies. The uninsured patient is like a pawn in this corrupt system; stuck in a vicious cycle revolving around doctors, the hospital and insurance companies.”
READ MORE EMERGENCY ROOM CHARGES LEGAL NEWS
The average hospital stay in the developed world costs $6,222. In the US, the average hospital stay (five days) costs $18,142. That extra $12,000 isn’t because of extra care or expensive technology: it is simply because American hospitals charge more than the rest of the world. And emergency room charges for uninsured patients are vastly higher still.
“Those of us with health insurance are also paying a hidden and growing tax for those without it - about $1,000 per year that pays for somebody else’s emergency room and charitable care,” said President Obama in 2009, making a case for his healthcare law.