Uninsured patients in Texas could have an easier time challenging excessive hospital bills in light of an April 27 ruling from the Texas Supreme Court, reports The Texas Tribune.
Here are six things to know about the ruling and its potential effects.
1. The ruling stemmed from a lawsuit filed by Crystal Roberts. Ms. Roberts received various services at North Cypress (Texas) Medical Center following a 2015 car accident, including X-rays and CT scans, according to the report. She later found out she was on the hook for more than $11,000 and subsequently sued the medical center over what she deemed as an excessive price.
2. As part of her legal challenge, Ms. Roberts sought information from the medical center about how much an insurer, such as Aetna, Blue Cross Blue Shield or Medicare, would have paid for the same services, reports The Texas Tribune. Texas law on hospital and emergency medical services liens states liens do not cover "charges for other services that exceed a reasonable and regular rate for the services."
3. North Cypress said it wouldn't provide the requested information because it was not material to the lawsuit and argued revealing "confidential and proprietary" insurance information would cause the organization "irreparable harm," according to the report.
4. The Texas Supreme Court sided with Ms. Roberts, ruling the information was material to her case. There was a caveat, though: the ruling states hospitals could ask the trial court to seal that information so it would be available to the patient but not the broader public.
5. Ms. Roberts' attorney James Amaro said the Texas Supreme Court decision ultimately means uninsured accident victims in similar situations will be able to more easily challenge excessive hospital bills with access to insurance information, according to the report.
6. Attorneys for NCMC did not return The Texas Tribune's requests for comment on April 27. However, Chad Ruback, one of the medical center's lawyers, previously told Law360 a ruling such as the one handed down April 27 "would, sadly, increase costs for all hospital patients," according to The Texas Tribune. Mr. Ruback also told Law360 he is concerned "this type of discovery tactic will routinely be used to strong-arm settlements of otherwise meritless claims against hospitals."
Read The Texas Tribune's full report here.
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