An Oregon man filed a lawsuit against Vancouver, Wash.-based PeaceHealth, alleging the health system secretly overbilled Medicare patients involved in accidents, according to The Lund Report.
The lawsuit, filed in the U.S. District Court for the District of Oregon, claims PeaceHealth overbilled Donald Griffith nearly $15,000 for treatment related to a car accident he was involved in during November 2015.
Mr. Griffith, who is disabled and has insurance through Medicare, claims after being treated at Eugene, Ore.-based PeaceHealth Sacred Heart Medical Center University District, the hospital bypassed billing Medicare and instead billed him for $14,574.83 in October 2017. A $98,691 settlement from his liability insurer for the accident was finalized the same month, and he received it in February 2018.
Under an exception to federal law that only applies to Oregon, Medicare providers like PeaceHealth must bill a settlement only if a health plan pays a member injured in an accident within 120 days after the individual files a claim or is treated, whichever comes first, according to the lawsuit.
"Since they didn't do that in this case, they cannot come back more than 120 days later and try to collect from the settlement," Michael Fuller, a class-action specialist and lawyer in the case, told The Lund Report.
A PeaceHealth spokesperson told The Lund Report the health system does not comment on pending litigation. The lawsuit seeks class-action status and three times the losses Mr. Griffith claims he suffered. The complaint alludes to hundreds of others who could join the case.