John Muir Health sued for allegedly overcharging patients

The law firm Hagens Berman has filed a lawsuit against Concord, Calif.-based John Muir Health accusing the health system of "unconscionable" billing practices.

The proposed class-action suit alleges the health system charged a patient more than $6,000 for a routine drug screening during an emergency department visit, according to an Oct. 4 news release from the firm.

The lawsuit alleges John Muir charges about 10,000 percent of the Medicare rate for the simple urine test, which has a Medicare reimbursement amount of $62.14. The firm also alleges the health system has been charging more than $5,300 for this drug screening since at least 2018. 

Hagens Berman also accused John Muir of unfair competition, violation of consumer protection laws and violation of the Rosenthal Fair Debt Collections Practices Act, according to the release. The firm is seeking repayment for a proposed class of emergency department patients who were allegedly overcharged. 

The firm said in February it was investigating alleged overbilling at the health system. 

John Muir Health denied the allegations in a statement emailed to Becker's.

"When a patient in a contracted plan comes to our emergency department, we charge no more than a patient’s deductible and copay or co-insurance," the statement read. "We do not balance bill the patient. When a patient has a deductible, it must be met before insurance will pay the remainder of a bill based on that plans contract with John Muir Health."

The health system also said costs are higher in the emergency department because "we must have expert physicians, nurses and staff, as well as comprehensive services available 24/7/365." Emergency room services must be provided during that single visit to ascertain whether a patient needs inpatient hospital care or can be safely discharged.  

It added that federal law requires that hospitals treat patients first and discuss payment after treatment to stabilize the patient's condition. 

"By law, hospitals are not allowed to discuss payment prior to treatment or give out price lists," the statement read.

The health system also said it does not have any record of complaints about the care provided, the charges or the bill, prior to the firm's news release announcing the lawsuit.

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