Denver (AP) —The Colorado Supreme Court expected to pay about $ 1,300 for spinal fusion, but ruled in favor of a woman who was charged more than $ 300,000 by a hospital outside Denver. bottom. It is not clear that she may be liable for this.
This week’s ruling in favor of Lisa French, who underwent two surgeries in 2014, follows many US state and federal efforts to help curb medical costs. By limiting or eliminating so-called “surprise billing” Demands increased price transparency for consumers.
so Unanimous opinionA Colorado judge signed an agreement on Monday prior to surgery at St. Anthony North Health Campus in Westminster, due to an additional charge due to the then secret price list of undisclosed services. I decided not to force her to pay her.
The French believed that St. Anthony was a provider in the network and expected to pay $ 1,337 from his pocket after her medical insurance covered the rest. However, an employee at her hospital provided her with an incorrect quote after apparently misreading her insurance card. In fact, the hospital wasn’t in the network, Reported by The Denver Post..
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The charge for France was $ 303,709. Her insurance paid about that amount of about $ 74,000. Centura Health, which runs a non-profit hospital, has filed a lawsuit for balance.
A lawyer at Centura Health argued that the French-signed contract specified that the hospital had to pay “all fees for the hospital,” including the price of services it maintained internally at the time.
However, the court ruled that the French never agreed to these accusations because they were not specifically mentioned in the contract.
Judges also declared that the internal database of such prices, called “Charge Master” rates, does not reflect actual care costs, as insurance companies often negotiate reductions to “in-network” rates. bottom.
Judge Richard Gabriel wrote in court, and in addition, chargemaster fees within the hospital “became more and more arbitrary and over time lost a direct link to the actual costs of the hospital. Private and Hospital benefits after considering discounts negotiated with government insurance companies. “
The proceedings withdrawn were first filed in a civil trial, and it was found that the French paid Centura Health an additional $ 767. The Court of Appeals later ruled Centura, deciding that the hospital could not predict the exact cost of treatment in advance and that the term “all fees” contained in the contract was obliged to pay the French in full. ..
“This should be the end of her line,” French lawyer Ted Lavender said after the Supreme Court’s ruling, adding that the French were “very happy with the results.” A Centura Health spokesman did not immediately respond to phone or email messages asking for comment on Thursday.
In recent years, Colorado, California, New York, Oregon and other states We have enacted a law designed to limit or prohibit sudden hospital charges. Federal law, “No surprise method” Effective January 1st, it provided consumer protection against practices.