Hagens Berman: John Muir Health Sued for Overcharging Bay Area Patients
California law requires that our client and other patients of John Muir emergency departments get the emergency care they need without having to incur unreasonable and unaffordable bills, said Tom Loeser, partner at Hagens Berman representing the proposed class of John Muir patients.
A class-action lawsuit filed today against John Muir Health accuses the hospital of “unconscionable” billing practices after it charged a Contra Costa County patient $6,095.70 for a routine drug screening at an emergency department visit, according to attorneys at Hagens Berman and the Law Office of Peter Fredman PC.
The lawsuit, filed in the Superior Court of California for the County of Contra Costa alleges that John Muir charges roughly 10,000% of the Medicare rate for the simple urine drug screening, a service which has a corresponding Medicare reimbursement amount of $62.14. In medical billing practice, 135%-140% of a Medicare reimbursement allowance is considered reasonable.
The lawsuit alleges the hospital’s billing practices are “unlawful, unfair, and fraudulent.”
The lawsuit accuses John Muir Health of unfair competition and violation of consumer protection laws, as well as the Rosenthal Fair Debt Collections Practices Act, and seeks repayment for a proposed class of John Muir emergency department patients who were allegedly overcharged.
“California law requires that our client and other patients of John Muir emergency departments get the emergency care they need without having to incur unreasonable and unaffordable bills,” said Tom Loeser, partner at Hagens Berman representing the proposed class of John Muir patients. “There are laws in place to protect patients from being charged an arm and a leg when they need medical attention, and we believe John Muir Health has violated these laws.”
The law firms are seeking to hear from other patients who received exorbitant bills for laboratory services after visiting a John Muir Health Emergency Department. Patients of John Muir Health who suspect they may have been overcharged can contact the attorneys for more information.
“The fact that the hospital is charging $6,000 for a routine drug screening is not disclosed in the John Muir billings,” according to attorney Peter Fredman. “If you received an exorbitant bill for lab services at a John Muir Emergency Department visit, you should get in touch with us,” he advised.
Punishing Patient Charges
According to the lawsuit, just after midnight on June 14, 2022, the plaintiff, Savannah Thompson, came to the John Muir’s Walnut Creek emergency department because she feared she may have accidentally overdosed on an illicit drug. Ms. Thompson was in the emergency department for less than three hours before staff sent her home. Through her employer she had Kaiser health insurance, which paid John Muir over $6,000 for the medical services John Muir rendered to her that night.
Nevertheless, John Muir sent Ms. Thompson a bill seeking over $7,000 in additional payments from her personally, the lawsuit states. The charges included over $9,700 for so-called “Laboratory” services related to blood and urine samples she gave that night. It was only after Ms. Thompson requested an itemization that she learned the charges included $6,095.70 for the urine drug screening – a test that Medicare values at $62.14.
The charge is unconscionable, the lawsuit alleges.
“The nature of emergency care is that patients cannot shop for services based on reasonable rates,” said Fredman. “In this case, John Muir never disclosed that it intended to charge Ms. Thompson 100 times the value for the procedure. California law protects consumers in these situations.”
Years of Overbilling
The lawsuit alleges that this is not an isolated incident. According to data filed with the California Department of Health Care Access and Information (HCAI), John Muir has been charging over $5,300 for this urine drug screening since at least June of 2018, increasing the charge each year to reach the current rate of $6,095.70. The lawsuit alleges that John Muir routinely administers the urine drug screening to its emergency patients. According to HCAI data, the lawsuit states, over 85,000 patients visited John Muir emergency departments in 2021 alone.
“There are likely many other Bay Area residents who were charged thousands of dollars for simple drug tests following emergency department visits, and we intend to fight for their rights to compensation,” Loeser said. “John Muir had no right to set charges so high for these simple urine tests and it had no right to seek payment for these charges from emergency room patients when they were not covered by insurance.”
Attorneys say all John Muir Health locations are under investigation, including Concord Medical Center, Walnut Creek Medical Center, Behavioral Health Center, San Ramon Regional Medical Center (Partner Hospital), Urgent Care Centers, Berkeley Urgent Care Center, Brentwood Urgent Care Center, Concord Urgent Care Center, San Ramon Urgent Care Center, Walnut Creek Urgent Care Center and Aspen Surgery Center.
Find out more about the patient billing fraud lawsuit against John Muir Health.
Hagens Berman is a global plaintiffs’ rights complex litigation law firm with a tenacious drive for achieving real results for those harmed by corporate negligence and fraud. Since its founding in 1993, the firm’s determination has earned it numerous national accolades, awards and titles of “Most Feared Plaintiff’s Firm,” MVPs and Trailblazers of class-action law. More about the law firm and its successes can be found at www.hbsslaw.com. Follow the firm for updates and news at @ClassActionLaw.
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