Financial Legal News Articles & Interviews

Nashville, TN There was a flurry of reports and studies about five years ago that found routine price gouging in emergency rooms nationwide, and it was worse for the most vulnerable populations – poor and minority patients. It appears that, no matter how advanced medical technology gets, many emergency room patients are left in the dark, and left with an unexpectedly huge ER overcharges bill.

Islip, NY A number of elements go into the calculation of emergency room fees. Apart from the cost of providing care, hospitals must factor in reasonable expectations that some bills will go unpaid and that insurance companies will try to negotiate certain charges down – sometimes because of suspicions of healthcare fraud. The net effect, however, is that patients pay more.

Clear Lake, CA On April 8, the DC Circuit Court, which has jurisdiction over Medicare cases, held that Medicare need not reimburse St. Helena Clear Lake Hospital for the cost of maintaining nonemergency room specialists on call. Without Medicare reimbursement, the cost of maintaining these doctors on call will ultimately be passed along to patients through higher emergency room charges.

Baton Rouge, LA No sooner has TeamHealth settled a $15 million class action lawsuit brought by physicians than it’s slammed with another class action claiming inappropriate ER billing and systematic overcharges from its central billing office which is controlled in a “cartel-like manner”. 

Knoxville, TN On October 27, 2021, UnitedHealthcare filed a lawsuit against TeamHealth Holdings in the Eastern District of Tennessee. UnitedHealthcare Services v. TeamHealth Holdings, the ER fees lawsuit, charges that TeamHealth routinely overcharged emergency room patients for minor medical needs. UHC, as the administrator for many of those claims, alleges that it overpaid by as much as $100 million. The company claims that TeamHealth’s tactics crossed the line from aggressive profit maximization to outright fraud.

Santa Clara, CA The No Surprises Act, that went into effect January 1, 2022 intends to provide protection against surprise medical bills such out-of-network bills for in-network hospitals and services such as an air ambulance ride (not ground ambulance) to an in-network hospital. But don’t be surprised if you get a surprise bill…

Knoxville, TN UnitedHealthcare claims that TeamHealth has submitted fraudulent claims to the insurer, to the tune of more than $100 million. The ER fees lawsuit claims that the emergency room staffing and billing company has been upcoding—using codes to deceive the insurer into overpaying—since 2016.

Kansas City, KS Tony woke up late Saturday night with a nosebleed and not knowing what to do, his son drove him to emergency room at St. Lukes South Hospital. When Tony got the bill in the mail he almost had a stroke--a doctor had simply inserted into his nose a cotton ball sprayed with decongestant, which took a few minutes, but he was billed $1,200. There had to be an error.

San Diego, CA “Not only are these inflated ER overcharges unethical – I don’t understand how medical professionals can charge exorbitant fees for such little work,” says Michael Cutler MD, an urgent care physician. “People were ordering tests before the doctor even came in the door.”

Atlanta, GA After waiting in the Emory Decatur Hospital ER for seven hours to treat a head injury, Taylor Davis couldn’t wait any longer and went home. She later received an emergency room bill for $688.35. Are you familiar with the old English proverb that “Children should be seen and not heard”? Here’s a new American phrase: “Patients are charged for not being seen.”