Premier Health and a surgeon who does contract work through the health network have asked a court to dismiss a lawsuit against them that claims they did not tell two patients they were receiving emergency care not covered by their insurance.
The patients were both taken to the emergency room at Miami Valley Hospital, owned by Premier, and were assigned Dr. Kenneth Christman, an on-call plastic surgeon. The patients said in the suit that they should have been told that Christman is not a hospital employee and does not contract with any insurance networks.
Because Christman does not have pre-arranged payment agreements with insurance companies, the patients’ claim they unfairly received high bills.
Premier and Christman filed responses to the suit recently, each stating that the law does not require either the physician or hospital staff to disclose insurance-status of physicians.
A motion filed on behalf of Christman by attorney Caroline Gentry, of Porter Wright, states “noticeably absent from the Complaint is any allegation that Dr. Christman made any representation to Plaintiffs, much less one that was false or misleading.”
The motion states that Miami Valley staff told the families that the hospital was in-network. But Christman, as a contractor, is not a hospital employee. His attorney states he is not legally obligated to tell the patients his insurance status.
“The initial question for this Court is whether such a legal duty exists as a matter of law. The answer is straightforward: Ohio law currently does not establish such a legal duty,” the motion states.
The court documents filed on behalf of Christman also state that he shouldn’t be sued for “unjust enrichment” since the patients haven’t paid the medical bills yet.
“If anything, he provided them with benefits (surgical services) for which they have failed to pay. There is simply no basis for asserting this claim against Dr. Christman, and it should be dismissed,” court documents state.
Court documents filed on behalf of Premier by Jeff Ireland, attorney with Faruki+, asked the judge to dismiss the suit and stated that Premier staff did not make any false statements to the patients. It also cited past case law to argue that the health network also had no duty to disclose any information about the practices of contract doctors at its hospital.
The original lawsuit filed May 2 in Montgomery County Common Please Court asked the court to declare their case a class action lawsuit.
The first plaintiff, Reid Rupp, of Oakwood, states when he was a student at Miami University December 2016 he was taken by ambulance to Miami Valley Hospital after a bicycle accident at school. He received plastic surgery for injuries to his face and jaw, the lawsuit states.
The lawsuit states their insurer paid Christman about $1,823, which the insurer considered to be a fair price. Christman said a fair price was $19,108. Rupp was eventually named responsible for a $17,031 balance.
The other plaintiffs are Ed and Kristen Garrett, the Sidney parents of a 17-year-old boy flown to Miami Valley Hospital October 2016 following a car crash.
The lawsuit states their insurer paid Christman $13,140, which its considers the amount that it would have paid if Christman was in-network. The Garretts were billed by Christman for a $9,458 balance. The Garretts’ insurer paid for all services except the balance of the bill they received from Christman.
“Upon information and belief, both Premier and Dr. Christman have received numerous complaints and grievances from patients over the course of years regarding their illegal and unethical conduct,” the lawsuit states. “Nonetheless, Defendants have knowingly and willfully continued the foregoing scheme because both Defendants gain financially by continuing to generate increased medical fees.”