A Florida federal judge Monday dismissed a proposed class action against three HCA Healthcare hospitals alleging they improperly billed patients undisclosed surcharges for emergency department care.
U.S. District Judge Roy Altman ruled that two of the three individual plaintiffs did not have legal standing to bring the lawsuit, saying the hospitals had not pursued collection action against them and therefore they suffered no harm.
Judge Altman tossed the third plaintiff's claim as well, determining his allegation that the emergency department facility fees were not disclosed was false. The judge cited the hospital's online publication of its chargemaster prices.
But the case could still go on. The third plaintiff can file an amended complaint by Feb. 17, 2020. The hospital failed to convince Judge Altman that the individual could never state a plausible claim that disclosure of the facility fee via publication of chargemaster prices is not an unfair trade practice under Florida law.
The lawsuit, filed last May, was based on the Florida Deceptive and Unfair Trade Practices Act.
Florida law protects consumers from surprise, out-of-network bills, but ED facility fees that may surprise patients aren't subject to that statute.
"A lot of things can surprise (consumers), such as not understanding their deductible," said Jack Hoadley, a research professor emeritus at Georgetown University's Health Policy Institute.
Miami attorney Walter Tache, who represented the three HCA hospital defendants — Poinciana Medical Center, Palms West Medical Center and Fort Walton Beach Medical Center — was satisfied with the ruling. He noted that a federal court in Orlando previously dismissed similar claims by these plaintiffs.
"We appreciate the work of both courts and continue to believe we have appropriately disclosed our charges and complied with the law," Tache said.
Neither HCA nor the plaintiffs' attorneys responded to requests for comment by deadline.
Plaintiff Timothy Shaw received treatment at the ED at Palms West Hospital in January 2019, and alleged he was billed an undisclosed surcharge of $1,642 on a bill totaling $5,437.
Nathan Haviland received treatment at the ED at Poinciana Medical Center in October 2016. He alleged he was billed an undisclosed surcharge of $3,935 on a total bill of $23,865.
Keith O'Leary's minor dependent received treatment at the ED of Fort Walton Beach Medical Center in December 2017. He alleged he was billed a facility fee of $1,567 on a total bill of $3,669.
The complaint argued that knowledge of the undisclosed surcharge or cover charge would be a substantial factor in patients deciding whether to visit a hospital and proceed with treatment there.
HCA and its hospitals argued that the emergency department charges were standard facility fees charged by hospitals and recognized by the CMS, and that they were disclosed through publication of the hospitals' chargemaster prices.
While ED facility fees are common practice, simply publishing them via the chargemaster prices is not adequate disclosure to patients, Georgetown's Hoadley said.
"That's not going to help them understand what it's going to cost, because the chargemaster is too complicated and in emergency cases, you're not in a position to shop for a hospital anyway," he said.