In a court case being cited as among the first of its kind, a Colorado woman won a decision against the hospital that sued her for an enormous unpaid bill. According to The Denver Post, St. Anthony North Health Campus sought legal action against patient Lisa French, claiming she owed the facility $229,112.13 for spinal fusion surgery performed in 2014. The jury ruled in favor of the patient, deeming the hospital charge to be excessive. French was ordered to pay $766.74 to settle the debt.
When French checked in for surgery, she had health insurance, so she didn’t worry about the expense of the procedure and recovery, believing it would be covered. According to French, a process server delivered her a bill three years later, after her insurer balked at the overall price tag in excess of $300,000.
Centura Health, which owns the nonprofit hospital based in Denver suburb Westminster, maintains the charges were aligned with the circumstances.
“The evidence presented at trial was that St. Anthony North’s charges are among the lowest in the community for services received by Lisa French,” Wendy Forbes, a Centura Health spokesperson told The Denver Post. “She had a very complicated surgery with major complications due to her personal, pre-existing health conditions. The charges were fair and reasonable and grounded in the fundamental economics of healthcare under our current system.”
The Denver Post reports that French signed a standard agreement obligating her to pay any costs not covered by insurance, but she was also told that her share would amount to $1,336. She paid $1000 to St. Anthony North ahead of the procedure.
During the trial, the defense called attention to the significant difference between the costs incurred by the hospital and the prices they charged. For example, the 13 implants used in the surgery were acquired by the hospital for approximately $31,000, but on the bill they tallied up to nearly $200,000. This markup was one of the factors that led the consultancy ELAP Services to advise French’s insurer against paying the bill.
“Our experience is that there is a lot of profiteering going on, and bills that have no rational relationship to the cost of the service,” ELAP Services CEO Steve Kelly told The Denver Post. “That’s what we’re trying to prevent. We don’t want our clients and families subjected to predatory pricing.”
Centura Health plans to appeal the ruling.
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