The Supreme Court of Virginia has agreed to review a case concerning whether a hospital can bill a patient at its listed, chargemaster rate for out-of-network services, reports Virginia Lawyers Weekly.
Glenn Dennis received emergency care for a heart attack at Memorial Hospital of Martinsville & Henry County in 2014. Prior to treatment, Mr. Dennis was asked to sign a financial responsibility agreement to continue receiving care.
Mr. Dennis was hospitalized two days and underwent surgery to place five stents in his arteries, according to the article.
Because the hospital was not his insurance carrier's network, Mr. Dennis received a bill for $111,115. His insurance paid $27,254. The hospital sued Mr. Dennis for the outstanding payment.
Last year, a HenryCounty judge ordered a hospital to accept 25 percent of its chargemaster rate for emergency services provided to an out-of-network patient. The judge based his ruling on testimony that showed the hospital offered patients a 75 percent discounted prompt-pay option.
The judge's decision is a rare judicial rejection of "balance billing," or the practice of accepting payment from an insurance company and then billing the patient at full price for the unpaid balance.
The hospital, which is owned by LifePoint Health in Brentwood, Tenn., appealed the ruling. The state Supreme Court has agreed to hear arguments.