Savannah Thompson walked into the emergency division at John Muir Medical Heart in Walnut Creek simply after midnight June 14, fearing she had ingested fentanyl — an artificial opiate answerable for a North America-wide epidemic of deadly overdoses — in what she had been advised was cocaine, in keeping with a brand new lawsuit accusing John Muir Well being of fraud.
Medical workers evaluated Thompson, gave her the overdose-reversal drug naloxone, together with intravenous fluids and an electrocardiogram coronary heart check, and took blood and urine samples earlier than sending her dwelling inside three hours of her arrival, in keeping with the go well with. After she left, the hospital firm screened her urine for medicine, because it routinely does with emergency room sufferers, the go well with alleges. Then John Muir Well being billed her $6,095.70 for the check, in keeping with the go well with, which is looking for class motion standing and accuses the hospital firm of fraudulent billing practices and breaking California consumer-protection legislation.
The charge charged to Thompson, a Contra Costa County resident, was nearly 100 occasions Medicare’s reimbursement fee of $62 for the check, the go well with claims, including that as a rule of thumb for medical billing, charging as much as slightly below 1 1/2 occasions Medicare’s reimbursement quantity is “thought-about cheap.”
State well being division information present John Muir Well being has been imposing an “unconscionable” charge of greater than $5,000 for the check since no less than 2018, and elevating the value yearly, the go well with claims. The standard price for the check in an emergency room within the area is $600 to $700, the go well with alleges.
John Muir Well being acquired greater than $6,000 from Thompson’s outdoors insurance coverage supplier, and needs her to pay an extra $7,100, the go well with claims. The laboratory-services portion of the overall invoice amounted to just about $10,000, the go well with alleges.
As a way to obtain emergency providers, Thompson needed to signal a contract the hospital requires, agreeing to pay in keeping with the “common charges and phrases” of the hospital, in keeping with the go well with, which included as an exhibit a duplicate of the signed contract.
John Muir Well being stated in an announcement Tuesday that the prices of medical care and exams “will at all times be decrease in an outpatient setting than in an emergency division or hospital,” and that prices are increased within the emergency division “as a result of we will need to have professional physicians, nurses and workers, in addition to complete providers obtainable 24/7/365.”
Federal legislation requires hospitals to deal with sufferers first and focus on cost afterward, so as to stabilize a affected person’s situation, John Muir Well being stated. “By legislation, hospitals will not be allowed to debate cost previous to therapy or give out tariffs,” stated the corporate, which operates hospitals, pressing care facilities and clinics in Contra Costa, Alameda and Solano counties.
“The claims is not going to stand up to scrutiny in a courtroom of legislation,” the corporate stated.
Thompson has made partial cost on her invoice however is unable to cowl your complete price, in keeping with the go well with.
It isn't clear what number of John Muir Well being sufferers had been billed equally for the check and will be a part of a category motion, the suid stated. State information reveals greater than 85,000 individuals visited John Muir Well being’s emergency departments in 2021, and the corporate ordered and billed for the check Thompson acquired in “a considerable proportion” of these visits, the go well with alleges.
Thompson is looking for a courtroom order forcing John Muir Well being to chop the check’s value to “truthful worth” and return to her, and others charged for it, any cash they paid past that worth.