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Tuesday, September 06, 2016

Ind. Decisions - "Parkview argues to keep its billing secret"

The Supreme Court oral argument last Thursday in Parkview Hospital, Inc. v. Thomas E. Frost, et al. (02A03-1507-PL-00959) (you may watch it here) is the subject of a Sept. 2nd story by Niki Kelly in the Fort Wayne Journal Gazette. Some quotes:

INDIANAPOLIS – Parkview Hospital argued before the Indiana Supreme Court on Thursday that it should not have to release information about charges and discounts it provides to insured patients.

The question is at the core of a dispute with Thomas Frost, who was catastrophically injured in a truck-motorcycle accident and taken by air to Parkview in October 2013.

He stayed in the hospital for more than a month and then transitioned to skilled nursing at Parkview Randallia. His total bill was more than $625,000. He did not have medical insurance.

Frost is disputing the reasonableness of the charges Parkview has sought under the Indiana Hospital Lien Act. His attorneys asked for information about discounts provided to patients who either had private health insurance or who are covered by government health care programs such as Medicaid and Medicare.

But Parkview has blocked the maneuver and asked the Indiana Supreme Court to reverse decisions by the trial court and Indiana Court of Appeals in Frost’s favor.

The court had not accepted transfer of the case at the time of the arguments. That means if the court denies the transfer, Parkview would lose the case and be forced to provide the requested information. If the justices accept the case the court would issue a ruling in the coming months one way or the other. * * *

Ed Chester, the attorney representing Frost, said a billing expert hired by Frost has determined the reasonable value of the services Parkview provided was $246,640 – about 39 percent of what was charged in the case.

He said rates from the chargemaster – the official list of charges for all procedures, services and goods provided by a hospital – ­aren’t intended to be paid. They are simply a starting point for negotiation between the hospital and insurance company.

It appears there was no negotiation or discount in the Frost case.

Fort Wayne attorney Tom Manges also argued for Frost on behalf of the Indiana Trial Lawyers Association, saying the Legislature has tried to rein in hospital billing in recent years. He said Parkview and other hospitals are very good at maximizing how much money they receive and that it’s relevant to compare Parkview’s costs with its markup.

ILB: Readers may remember an earlier, similar case from 2012 where the Supreme Court, to quote a Star story from the time, "reversed an appeals court ruling that let two uninsured patients sue IU Health over hospital bills that were much higher than insured patients were charged for the same care." See also this ILB post from March 21, 2016.

Posted by Marcia Oddi on September 6, 2016 08:45 AM
Posted to Ind. App.Ct. Decisions