Two patients are seeking class-action status for a lawsuit filed May 2 against Dayton, Ohio-based Premier Health and one of its surgeons, arguing they were unlawfully charged an out-of-network rate despite going to an in-network hospital, according to The Dayton Daily News.
The lawsuit involves two cases of surprise billing at Miami (Ohio) Valley Hospital, which is operated by Premier. The first plaintiff, Reid Rupp, 20, was transported by ambulance to Miami Valley Hospital after a bicycle accident in 2016. He received plastic surgery for his injuries from the on-call plastic surgeon, Kenneth Christman, MD. Despite Miami Valley Hospital being an in-network hospital for Anthem, Mr. Rupp's insurer, Dr. Christman was an out-of-network physician. As a result, Mr. Rupp was hit with a $17,031 medical bill. The lawsuit claims neither Dr. Christman nor Miami Valley Hospital disclosed that the on-call plastic surgeon was out-of-network before the surgery.
The other plantiffs are the parents of 17-year-old Ed Garrett, who was flown by helicopter to Miami Valley Hospital in 2016 after a car accident, where he received plastic surgery for his injuries by Dr. Chistman. The plastic surgeon again was out-of-network for the Garrett family's insurer, landing them with a $9,458 medical bill.
The plantiffs argue they were unlawfully charged high medical bills because they strategically went to an in-network hospital for care, but were unknowingly given an out-of-network plastic surgeon. The lawsuit is seeking to declare the billing practice unlawful. The patients are seeking undisclosed damages as well as reimbursement for attorney fees.
"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 reads, according to The Dayton Daily News. "Nonetheless, Defendants have knowingly and willfully continued the foregoing scheme because both Defendants gain financially by continuing to generate increased medical fees."
Premier Health declined to comment on the pending litigation.