Indiana supreme court could review hospital chargemaster, pricing practices

Last week, an Indiana appeals court strongly suggested the state high court review a 2012 decision that held hospitals needn't defend the reasonableness of nor share their chargemaster prices, reports The Times.

Four years ago, the Indiana Supreme Court dismissed a lawsuit brought against Frankfort, Ind.-based Clairan Health Partners by two uninsured patients that challenged the hospital's right not to share its chargemaster with patients prior to signing a service agreement.    


Under Indiana law, if exact prices for services are not known by either the consumer or the service provider up front, the service provider must offer a "reasonable" price.


In the 2012 decision, the court ruled that if a patient signs a service and payment contract without a price listed on it, the patient is accepting the undisclosed chargemaster rate. 


The precedent set in 2012 could now get a second look after an appeals court ruling last week.  


The appeals court ruled a man billed $629,386 following a motorcycle accident has the right to challenge the reasonableness of Fort Wayne-Ind. based Parkview Hospital's pricing by presenting evidence of lower rates paid by insured patients for the same services.


"Mr. Frost is not challenging that a debt is due to Parkview. Likewise, Mr. Frost is not asking a court to impute a reasonable price...or asking a court to completely disregard Parkview's rates," Senior Appeals Judge Ezra Friedlander and Chief Appeals Judge Nancy Vaidik wrote in the court's opinion. "Instead, he may challenge the reasonableness of the charges claimed, and is entitled to discovery from Parkview in order to do so."


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