Ore. Health & Science Univ.billed uninsured ER patient 'unconscionable' $31,000, says $7 mil. suit

[dixiegrrrrl]

An uninsured woman who went to OHSU Hospital's emergency room and left a week later not knowing she'd soon be billed $31,000
is suing the hospital, claiming it charged her far more than it would have charged an insurance company for the same services.

Claire Amos' lawsuit claims that she and many other uninsured emergency room patients at OHSU have been kept in the dark
about how much their treatment cost until they received their bills in the mail.

Amos also claims that murky hospital admissions paperwork didn't reveal that she or other uninsured patients would be billed at "dramatically higher" rates than patients with coverage from insurance companies, Medicare and Medicaid.

Such practices are "unconscionable," says the lawsuit, filed Friday in Multnomah County Circuit Court.
It seeks class-action status and asks for an estimated $7 million for Amos and hundreds or possibly thousands of others.

http://www.oregonlive.com/portland/index.ssf/2015/09/ohsu_charged_uninsured_er_pati.html

Yet another reason you need the single payer insurance that I have.....

[dixiegrrrrl]

1. btw....It is now against the law if you are a Non-profit hospital, like OHSU, to charge the uninsure

Nonprofit hospitals like OHSU, must let patients know if they qualify for free or reduced-price care if they dont have health insurance or their insurance leaves them with gaps causing large bills, according to the Affordable Care Act (ACA)s new Section 501(r) rules.

http://www.ajmc.com/newsroom/many-nonprofit-hospitals-fail-to-notify-patients-who-qualify-for-charity-care

If you don't have insurance, go to a non-profit hospital.

[UglyGreed]

2. I still am waiting to find out

if I am on the hook for being admitted through the ER even though I'm covered under my wife's insurance.

[HuckleB]

3. This is from September 2015. Is there any updated information? -eom-

[gratuitous]

31. Plaintiff filed a notice of voluntary dismissal yesterday

Looks like the case is going away, but the plaintiff's notice isn't very detailed. It doesn't appear there was a settlement, although OHSU had filed Rule 21 motions against the complaint. It may be that OHSU pointed out that plaintiff has insuperable difficulties in pleading a cause of action under Oregon law.

[HuckleB]

32. Interesting. Thanks.

I guess, as with many legal matters, we may never know the full story.

[CBGLuthier]

67. My wife had a CT Scan. It cost a little over 200 dollars. Total. No insurance.

I go to see a doctor she charges 35 dollars a visit. Total. No insurance.

I buy BP medicine. A 6 month supply costs about 80 dollars. My wife is on medicine that was costing 400 dollars a month WITH insurance and now she gets it for about 30 dollars a month. Again no insurance.

All we had to do was leave the US and go to a country that doesn't let its citizens be gouged. Too bad we have to leave soon but fortunately we will be stocking up on pills before we go.

Health care in America is a fucking scam and a fucking shameful thing.

[Kip Humphrey]

4. I was in the ER for 12 hours... was billed $15,000 with no diagnosis.

I had no insurance so asked the hospital if they would negotiated down the bill to Medicare rates +10%. They refused saying they did not have to negotiate with me. I then asked for an itemization of charges which they also refused to provide saying they were a private, for-profit hospital and were not required to itemize the charges, further claiming that they could charge whatever they wanted. So, I didn't pay them.

[saturnsring]

5. so you just let everyone else pay for your services, how gracious of you

[Kip Humphrey]

6. I strongly considered intentured servatude to placate such as you.

FYI, my offer stands with the hospital. But you seem to imply charging anything they want, especially to those who cannot afford it, is perfectly acceptable to you. How gracious of you!

[saturnsring]

12. i implied no such thing but How gracious of you! to put words in my mouth

[yeoman6987]

27. I get what you did and what can you do?

But I always worry about that credit report.

[metroins]

52. Medical bills are easy to get off credit

[liberalhistorian]

60. Since last year, medical bills can no longer

be put on credit reports, FINALLY. That was a long time coming, but justice finally prevailed.

[yeoman6987]

61. Thank you. I didn't know that.

[Mariana]

64. Bankruptcy because you paid medical bills

you could not afford to pay looks worse, I imagine.

I also did not know that medical bills are no longer reported to credit reporting agencies.

[HuckleB]

8. You pay bills without itemized charges being provided?

[saturnsring]

10. shouldnt people pay their medical bills?

[SalviaBlue]

15. Surely you are not suggesting that he should pay

a bill that does not itemize the charges.

That is insane.

Would you pay a restaurant bill without seeing the itemization? Would you pay a grocery bill without an itemized receipt?

I applaud the poster who refused to pay. He is not the problem, as you imply.

[saturnsring]

16. of course he shouldnt pay other poeple will pay it for him in high medical costs

nor do i feel like arguing about it

[SalviaBlue]

24. You are implying that medical costs are high because

some people don't pay their bills. You are blaming the victim. Medical costs are high because we allow a for-profit system to operate in our country.

You are doing the profiteers job for them.

[saturnsring]

25. it is at least both. hospitals arent just going to eat 15grand they'll pass it on in the form of

higher prices

[dixiegrrrrl]

40. Not only are you correct, here is a perfect example:

Florida Is the Nation's Capital for Hospitals That Price Gouge Patients
http://www.miaminewtimes.com/news/florida-is-the-nations-capital-for-hospitals-that-price-gouge-patients-7672333

The Miami New Times article has a couple interesting items.

This one:

Consider the fact that 49 of those hospitals are for-profit centers, and 14 of those are operated by Hospital Corporation of America (HCA).
Who is the former CEO and chairman of HCA? Gov. Rick Scott.

and this:
50 hospitals charge uninsured more than 10 times cost of care, study finds
https://www.washingtonpost.com/national/health-science/why-some-hospitals-can-get-away-with-price-gouging-patients-study-finds/2015/06/08/b7f5118c-0aeb-11e5-9e39-0db921c47b93_story.html

June 25, 2015, when the Post was still the Post.

For the most part, researchers said, the hospitals with the highest markups are not in pricey neighborhoods or big cities, where the market might explain the higher prices.

( No competition)

Speaking of price gouging, I took that MRI the doc ordered, and checked on prices for it across the country..there are websites that check on those things, I googled.
Prices differences were DRAMATIC, even in the same state, ranging from 300.00 to 7,000.00.
The average was around what our hospital was charging.

don't even get me started on the price differences of operations in Canada or Mexico than here
or prescriptions.

[dixiegrrrrl]

46. "nor do i feel like arguing about it "

Your reply is an example of what I meant in my comment #35.

[Hassin Bin Sober]

65. I'm a contractor. Anytime you need work on your house you be sure and call me.

I need a new boat.

[HuckleB]

22. People should know what they're paying for before they pay bills.

[saturnsring]

23. that is true- thing is s/he does know what theyre paying for

s/he went to a hospital for a reason, they fixed what ever that was and that's what thyre paying for. the poster wants a itemized list which s/he should be entitled to.

[Ghost in the Machine]

28. You just lost your debate on this, with your own words. Do you remember what you replied to?

Here it is...

4. I was in the ER for 12 hours... was billed $15,000 with no diagnosis.

Please point out where, exactly, that the poster stated, or implied, that "they fixed what ever that was and that's what thyre paying for" <----- YOUR WORDS

Thanks in advance,

Ghost

[saturnsring]

35. well im not debating there isnt a point.

the poster went into the er spent 12hours there ran up 15grand in bills im sure it wasnt to just sit in the lobby -

[dixiegrrrrl]

42. Ya know, you post a disagreement ( which sounds a lot like an attack )with what posters say here,

then when they address your disagreement, you keep replying that you not debating ( which is the purpose of a discussion board like this one)

You might not be surprised if people catch on REAL quick and simply ignore your attempts to bait them.

Welcome to DU.

[saturnsring]

53. i posted this "so you just let everyone else pay for your services, how gracious of you"

is the statement false? doesnt the hospital pass those charges on to everyone else who uses it?
i made a simple statement and was piled on so i answered questions there was no debate

[Ghost in the Machine]

51. 12 hours, and no diagnosis.. that means *still don't know what's wrong*.... I would want an

itemized bill before I paid, too. When I had my neck surgery, the hospital tried to charge the insurance company $25 EACH for every pain pill they gave me for the week I was in there, $10 for EACH gauze pad they used and even tried charging for the use of the sheets and blankets!

Back in 1999, I was in an ATV accident. I flew about 15 - 20 feet through the air and landed on my head and shoulder first. I jumped right up and ran back over to where the 4 wheeler and some friends and family members were. I was taking off my helmet as I got near them, and when I got beside them I could hear them talking, but they all sounded like they were in a barrel a mile away. I knew right then I had a concussion, and my shoulder was hurting. Everyone wanted me to go to the ER, but I didn't want to right then... I was covered in mud. My girlfriend watched me throughout the night because of the concussion, and I had taken a shower, washed my (very long) hair and was able to use my arm.... I think because I was probably in shock, too.

The next day was a different story. My shoulder hurt like hell, and I could barely move my arm. I had my GF drive me to the ER to get checked out. They took X-rays, told me "well, there is nothing broken, but you may want to follow up with an Orthopedic doctor if you're not any better within a week" and gave me a prescription for pain meds. This was on a Sunday afternoon. By Wednesday, I had lost total use of my arm. I kept telling myself that ?I think I would feel so much better if I can just get my shoulder to roll back some". I put my elbow in the palm of my good hand, pushed up a little and rolled my shoulder backwards. There was a real loud popping sound, my shoulder dropped down, and feeling immediately came back all the way to my finger tips! Yeah, my shoulder was DISLOCATED all that time and I reset it myself!

I would like to think that the ER doctors and a radiologist could tell that my shoulder was dislocated, but they never told me. I fixed it myself, and even did my own physical therapy for about a month to regain full use of my arm. I didn't have insurance at that time, and I never paid the bill, either. I felt that they didn't give me the proper treatment OR diagnosis. If they would have told me that my shoulder was dislocated and I NEEDED to go to an Orthopedic Doctor, I would have made payments. I was making over $1,500/week at the time. To me, it was a matter of principal because I felt that they didn't treat me right because I didn't have medical insurance. When I went in, before they even asked what happened or did anything, all they wanted to know was "was this a job related injury with worker's comp or an automobile accident with insurance coverage?" When I said no to both, and no I didn't have medical insurance, it was like they just herded me through and got me out the door.

Peace,

Ghost

[saturnsring]

54. peace to you to ghost

[Ghost in the Machine]

55. Thank you, saturnsring, and a belated Welcome to DU. I hope you enjoy the experience, this is

a great site, very educational and very humorous at times. People don't always agree, and it can get downright nasty at times, but I prefer a civil debate even if neither person is apt to changing their mind. Civility goes a lot farther, and you may find that you can disagree with someone on one subject, but agree 100% on many other subjects.

Peace within, Peace between, Peace among...

Ghost

[saturnsring]

56. thankyou ..... nt

[lumberjack_jeff]

26. THE people should pay OUR medical bills

The idea that services upon which your life depends can be treated as a supply and demand commodity has been proven stupid.

[saturnsring]

30. i 100% whole-heartily agree with you

[dixiegrrrrl]

33. Given the way medicine and insurance is being run today

you do realize you're paying "protection" money to one bunch of gangsters to keep another group of gangsters from breaking your financial knees. And the two gangster groups are in cahoots.

[saturnsring]

37. so because of that we can use the hospital and then not pay for the service?

[dixiegrrrrl]

44. Your comment is a straw man fallacy, pls see my comment # 35, above. n/t

[liberalhistorian]

59. If an entity is going to charge me the equivalent

of three cruise vacations or four trips to Europe for just twelve hours of their so-called "services" and then refuse to even provide any kind of itemized list of charges at all as to what, exactly, they're charging me FOR, and then refuse to even work with me at all so that they can get at least some of their money (and what average person has 15 grand just lying around to give to a hospital anyway?) you'd better believe I'd have a problem with paying them. I want to know WHAT specifically I'm paying them FOR and that I'm not just being used as a cash cow to pad their already-gargantuan executive salaries (most hospital CEO's make well into six-figure salaries while they stiff most everyone else who works there). They should not be permitted to just charge whatever the hell they want with no explanation or accountability. And if someone has an emergency medical situation where they must seek treatment, they shouldn't be used as a cash cow either. Health care, especially ER visits, is not often a "choice", it's not like charging a bunch of stuff you want on a credit card or taking a luxury vacation or anything like that. It involves our very lives at times.

And they can and often will take your house or anything else you own of value and garnish your wages as punishment for daring to get sick or injured and seeking treatment for it. I will never, ever feel sorry for hospitals, they are some of the worst collectors known in this country. The industry is in the top five for bad and aggressive collection practices.

I had an MRI for a severe shoulder injury recently and was charged nearly FIVE THOUSAND DOLLARS for less than an hour in the damned machine. Now the hospital is claiming insurance denied the charge and is demanding it ALL from me now, even though my insurance says no, we paid for it and sent the check on such-and-such a date. I have direct evidence from my insurance that they DID pay it, but the hospital is still claiming no they didn't and demanding its money or else (they're shit out of luck with us, we own no property or real estate and have few other assets they can suck from us so fuck them). First of all, the charge is ridiculous and it's supposed to be a non-profit hospital. Secondly, I'm not paying them a fucking dime when insurance already paid it and we pay the insurance company six hundred a month for premiums (and we can't complain about their service, frankly, because it's low-deductible and they have great coverage). This happens all the time and hospitals pull this shit daily.

[Mariana]

66. Yeah, they'll scam you if they can.

If you die, some of them will go after your family members - parents, siblings, adult children. They'll try to convince people who are in no way responsible for your bills that they have to pay them. One of my mother's friends was scammed that way by a hospital when her adult son died.

[HuckleB]

7. Which hospital system is it?

They were clearly doing whatever they could to get you to pay without allowing you the information you would need to challenge any charges. Not good. I can't see how it's legal, either.

[Kip Humphrey]

9. Memorial Hermann (Texas)

[HuckleB]

18. According to the web page, it's a nonprofit.

There should be more recourse for you.

[Kip Humphrey]

20. but according to the particular hospital's business office, hey are for-profit.

[HuckleB]

21. Well, you might want to look into it further.

Or go up the ranks of people there.

[Orrex]

11. I want to call BS on your "non itemized bill" story

But I've seen it happen. What a rigged game, and what a load of shit.

[dixiegrrrrl]

38. You know what else is a game with charges?

Hospitals/Doctors are one of the few services where they do not tell you their usual charges up front.

We negotiate with people who fix our house, so insurance will pay..you know, get three bids, choose one.
We negotiate with the car repair people.
We negotiate to BUY the car.
I even negotiate about prescriptions, cause there is competition in our town.

But when I called our only local hospital for charges for MIR, the first thing they ask is....what kind of insurance do you have?
and if you do not have insurance, you will get ..."it varies".

Hardly anyone will think to ask the cost before then make a Dr. appt, so it is our bad.

[Orrex]

45. And we hear a lot about the need to "shop" for healthcare

But since the prices aren't disclosed in advance, and you have no idea what they're going to do with you once you're in the hospital, and since you can't very well leave one hospital to have a procedure done at another and then return, they've totally got you over a barrel.

Yeah, it's bullshit.

[WillowTree]

17. In over 40 years in a related business, I've never heard of a hospital not sending an itemized bill.

Not once.

[haele]

19. Our household recieved two emergancy room bills without itemization this year.

One sheet of paper for each ER visit where the invoice stated "Your insurance negotiated the cost of this visit to $xxxx.xx, and paid $xxx.xx. You owe $xxx.xx" You may also receive charges for other services associated with this visit.

This was from a major private hospital/medical practice network in our county. This was a change from a spate of ER visits we had two year prior, where there was five pages of itemized invoice for each visit. I chalked it up to Anthem/Blue Cross's latest practice of not actually paying the hospital/clinic if the bill is going to be over $100 (instead, they now send us a check to pay them the insurance company's portion of the bill three months later) but now that I think about it, it could have been a change in billing service vendors made by the hospital system.
The invoice looked different this year than it had in previous years.

I had to go through the frik'n insurance website to find the coverage of benefits for that visit to find out what the hospital billed and what we were actually on the hook for.

Haele

[WillowTree]

57. And they wouldn't send you a copy of the itemization when you requested it?

[haele]

63. First, I had to deal with the HIPPA issue - bills were for spouse and adult daughter.

Second, while I did contact them and request the information on the phone or e-mail several times - because I couldn't just take off work and sit in the ER billing "services" office during their hours - it dragged for almost four weeks before I just said "F" it and spent two hours with my insurance company to find out what was on the invoice. In fact, the billing vendor for the ER tried to send the bill to Medicaid after I started questioning the bill, which confused the issue even more - because my husband was disabled, even though he wasn't on Medicaid.

The hospital system sends out different invoices for doctor's, labs, and clinic visits. They haven't been able to help me with the ER billing issues, I now have to contact either my insurance or the vendor providing the billing to get an itemized bill.

Again, this is a totally new situation we've been experiencing, and I've already contacted both the hospital system and our benefits coordinator about it.

Haele

[dixiegrrrrl]

34. Willow, I will tell you we got such a bill. Twice. 4 years ago.

They stated it was for 3 days of hospital care, ICU. Collapsed lung.
they DID not break it down to what services.
I had to call the hospital and demand an itemized bill.
Mr. Dixie did not have insurance then.

I was able to get the bill reduced, because it is a non-profit community hospital ( tho tries to act like a for profit)

2years later, he has Medicare, we automatically get itemized bills, plus helpful and prompt answers from the hospital if I have any questions.

Interesting how they respond to an insurance covered patient.

[WillowTree]

58. I think I wasn't as clear as I might have been.

What I should have said is that I have never known of an instance when, if they initially just sent a "balance due" bill, a hospital refused to send an itemized bill when one was requested. I'm glad that you did manage to get your situation straightened out.

[Vinca]

13. That's pretty much a standard procedure, although I'm surprised they weren't willing to negotiate.

Anyone who is covered by insurance gets a bill that shows what the hospital charge is and then what the insurance company has agreed to pay for the procedure. End of story. For the uninsured, they get a bill for what the hospital charges and that's that. I'm wondering why the woman was uninsured. What she an anti-Obamacare person making a protest or did she fall through the cracks somehow? This is why we need single-payer with automatic coverage as a right of citizenship.

[pnwmom]

14. No, it would be a reason to have an ACA plan -- and she's in a Medicaid state

with subsidies for people up to 400% of median income, so she doesn't have that excuse.

It's wrong that hospitals charge this way, but that is one of the reasons that the ACA was necessary. If she'd had the most bare bones policy available, it still would have given her access to the negotiated rates.

[7wo7rees]

29. This all seems so sad and bizarre. Many yrs ago my ex

had failed to enroll me in a timely manner with his company, (Motorola). I needed surgery, turned out it was minor and my brother was a rep for company selling laproscopy at the time and helped me with referral.
Because I did not have insurance the hospital (one of the tops in Dallas) negotiated my bill. A few weeks after it was all said and done, finished with and paid for I received a bill, itemized, for about 6 times what we paid. This bill had been accidentally sent and was shocking in what the hospital was going to charge insurance company.

How and when did it go the other way?

[dixiegrrrrl]

36. There was time when insurance companies did not rule medical charges.

Late late 1960's./1970's. I had 2 kids, we paid out of pocket, on a blue collar paycheck, all gyn appts, and hospital births, etc .....

Both kids saw Dr. for routine shots and few minor cuts, no problem paying.
Husband broke his collar bone doing some damn fool thing...no problem paying.
Prices were reasonable. Insurance was not a common thing back then. They were pushing life insurance, but in our smallish West Coast town, not health insurance.

Forward to 2005. We see a GP here, small rural town Office visits 50.00. No problem paying out of of pocket.Cheaper than any premium.

Come the Health Access Act. Office visits immediately shot up to 100.00.
Happily we now have medicare, so pay for one visit ( deductible is 147.00 a year).

[7wo7rees]

39. So as I said Bizarro world, upside down! What the hell is

going on? I talked with someone yesterday who moved to Boise from Waco. As soon as he got to Boise he had open heart surgery. The cardiologist in Waco did not think he would survive so had decided to let him die. He laughed about it yesterday. Death panels, anyone?

He is the widower of the woman who ran the Peace House in Crawford. She died in March of 2013.

[dixiegrrrrl]

41. Cutting off Medicaid, Medicare and Obamacare ARE death panels.

I was against Obamacare because it was perfectly clear that we would be forced to buy over priced insurance,
instead of having a law that made insurance more affordable ( Like Medicare)
or a law which addressed price gouging of doctors and hospitals.

sure enough, one year after the Health Act was passed, turns out insurance companies were given more or less monoploies in certain areas
AND they immediately raised premiums sky high.

did I mention they wrote the law?

We needed medical cost reform.
weren't gonna get it given the Congressional make up.

But we need it, and Bernie is proposing it.

[7wo7rees]

43. With you 100%!! We are paying $800 a month and

deductibles are so high we put off care! Huge rip off. There should not be health care for profit or prisons. The for profit, shareholders, Wall Street are killing us all.

Sorry, don't mean to be too overly dramatic. But damn it all.

(The 800 is just for the 2 of us, no kids)

[dixiegrrrrl]

47. I do not hear you as being too dramatic at all.

You are paying TWICE what we pay for our mortgage.
or
the low end of average rental for a single bedroom apt in most places
or
a very good monthly food bill

or 4 times what WE pay each month for Medicare premiums........just basic Medicare, no extra plans.

THIS...is the problem. and it has to stop before it kills us, and ours.

[7wo7rees]

48. I am very depressed about it.

Make too much but not enough. Fuck Texas and the ACA.
Why if we are paying so much can we not get dental care?

Yep, it is a mess, but hey we all are in it together, right?

Part of why we are hoping for Bernie. In TX though it is a long shot!

Trump, Cruz or rubio appear to be our future.

We have a sad!! Big-time!!

[dixiegrrrrl]

49. Ahhh..you are in Texas.......I'm sorry.

(said she, in Alabama)

[7wo7rees]

50. Right. Explains it all for the both of us! Peace.

[ecstatic]

62. I hope this goes all the way to the supreme court. nt

[dixiegrrrrl]

68. See post #31...

claim was dismissed.
I WOULD like to see a racketeering charge about artifical high medical prices. They are way beyond a sane profit level, and not much competition.