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Following a report on the increase of bankruptcies being filed because of unpaid medical care, comes a class-action lawsuit against Charleston Area Medical Center for overcharging uninsured patients.
Charleston newspapers reported, "In 1997, Verna Gibson went to Charleston Area Medical Center's Memorial Hospital after she began having heart troubles."
"The hospital treated her even though the $5.25-an-hour state worker had no insurance and no money to pay."
"She had no idea at the time that she was stepping into a financial nightmare, according to a lawsuit filed by her lawyers Monday."
When she couldn't pay, the medical center sued her and obtained a lien against her Charleston house, according to court records.
CAMC has sued lots of poor and uninsured people who could not pay, while at the same time writing off millions in uncompensated care.
Much of the issue is muddled in the complicated world of how providers charge for service and what kind of special deals they are asked to make by insurance companies and government agencies.
There is cost shifting all over the reimbursement field, providers will say, in order for them to stay above water.
In the suit, many patients were charged far more for medical care than insured patients.
Hospitals make money through their discounted rates.
"The basis for which [CAMC] receives its tax exemption is to provide charity care for those who can't afford to pay," said John Crongeyer, an Atlanta lawyer who represents Gibson.
"By charging uninsured patients substantially more than all other patients, [CAMC] is not only taking advantage of the government and deceiving the community, it is getting a free ride off of the taxpayers' backs."
A CAMC spokesman indicated such lawyer "attacks" just increase the cost of health care and "divert attention from the delivery of quality health care."
"The hospital's charity care policy calls for free care to all patients who apply and whose income and assets meet appropriate standards," said CAMC.
Hospital bills, driven by insurance companies and government regulations, have become complicated devices to attempt to collect money.
USA hospitals have come under scrutiny for their billing practices and have been criticized for employing collection agencies, suing people who could not pay and charging the uninsured full price while giving deep discounts to insurance companies and the government.
Sonia Chambers with the WV Health Care Authority, told the Charleston Gazette "People have a legitimate concern that uninsured patients pay much more than patients who are covered under private insurance plans. It is a real hardship for uninsured folks, it absolutely is."
A group of class-action lawyers led by Richard Scruggs, a Mississippi lawyer, began filing lawsuits accusing not-for-profit hospitals in more than 20 states for overcharging the uninsured by charging them full price for their services.
CAMC says they responded after the lawsuits began, giving discounts to the uninsured and setting up payment plans to people who could not pay.
Steve Summer, head of the West Virginia Hospital Association said the members of his group took the initiative and everybody agreed that this is the kind of thing to do.
The trouble starts with the way hospitals get paid. The largest payers for medical service refuse to pay list price for services. Instead, the government and insurance companies demand discounts.
The list price for services keeps going up and up to attempt to collect enough money for services to be provided.
Meanwhile, the answer to the collapsing health care system, is for the public, the government, the providers, the insurance companies and their managed care arms and the lawyers, to either ignore the problem, blame each other, sue or take out bankruptcy.
A family, according to BC/BS of West Virginia, will soon be paying $16,000 a year for family coverage.
Most businesses are continuing to drop insurance on their employees or down-size the coverage.
The CAMC suit claims hospitals never inform uninsured patients that they will charge them far more than most of their other patients, saying CAMC and other hospitals hand walk-in patients a form contract promising that they will pay in full for their medical care and tell them they must sign it to get care.
The class-action suits against CAMC claim they violated the state's consumer protection laws, dealt with uninsured patients in bad faith and unjustly enriched itself.
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