A South Carolina judge denied Greenville, S.C.-based Prisma Health's bid to dismiss a proposed class-action lawsuit accusing the system of overbilling Medicaid patients, The State reported Oct. 8.
Four things to know:
1. The lawsuit was filed in 2021 by the mother of a child who suffered a permanent injury at birth and, as a result, is a qualified Medicaid beneficiary and requires frequent medical care, according to the report.
In December 2020, the mother received a bill from Prisma for Medicaid-covered services. She spoke to Prisma and thought the issue was resolved, but allegedly received a notice from Prisma informing her of the outstanding balance and stating that she would be sent to collections if she did not make payment arrangements. She did not pay the bill.
2. Prisma argued in legal filings that the mother did not suffer injury because she did not pay the bill, according to the report.
"At best, (she) received a medical bill that she was not supposed to receive and had to make a phone call to Prisma requesting that the bill be re-submitted to Medicaid," Prisma's lawyers argued in the filing.
3. The judge ruled that the woman "did, in fact, suffer injuries and damages by receiving an unauthorized balance bill for covered services, through lost time and resources," according to the report.
The judge also ruled that the woman's lawyers can begin conducting detailed discovery and ordered Prisma to produce thousands more documents than the system has already handed over to the woman's legal team.
4. Prisma told The State that it does not respond to active litigation and declined to provide comment.