PIP (Personal Injury Protection) Benefits plays a large role in how my clients receive medical treatment. As a personal injury lawyer and for the sake of my clients, I have to monitor their PIP benefits and make sure that no health care provider takes advantage of their PIP payments. It is not surprising to me that a hospital is accused of using the majority of the medical benefits as we see facilities order numerous tests that sometimes don’t even pertain to the injuries the client had at that time.
Insurance News online reports that individuals have filed a lawsuit accusing HCA-operated hospitals in Florida of rapidly depleting the medical benefits included in automobile insurance policies by charging as much as 65 times Medicare rates for rendering medical services to accident victims. The lawsuit alleges HCA hospitals of targeting personal injury protection benefits, which are mandatory under Florida law. Such benefits provide a standard $10,000 of coverage for medical care to victims of automobile accidents, regardless of who is at fault. Some of the allegations in the complaint including the following: one patient treated at HCA-owned JFK Medical Center in Palm Beach, Florida was charged $5,900 for a CT scan of her spine, $6,404 for a brain scan, $3,359 for a lumbar spine x-ray and $2,222 for a thoracic spine x-ray. It points out that the Medicare rates for those scans are $479 combined. Uninsured patients are charged less than $3,500 for a CT scan at that facility, according to the lawsuit. That patient was left to pay $6,500 in hospital charges after her coverage reached its cap and another $4,000 in post-discharge medical services.
Another patient treated at Memorial Hospital in Jacksonville, Florida was charged more than $13,000 for two CT scans. “They are purposely overcharging and thus taking the money from those needing the medical care and help,” Theodore Leopold, attorney for the plaintiffs, told InsuranceNews.net. Hospital officials defend their billing practices stating that the coverage limits are currently insufficient. They “have not kept up with inflation and the cost of healthcare generally,” Linda Quick, president of the South Florida Hospital & Healthcare Association, tld InsuranceNews.net. “What you can get for $10,000 is nowhere near what you used to be able to get for $10,000.
The case is similar to one in Kansas City, Missouri. Last year, St. Luke’s Health ended up paying $3.5 million to settle. The hospital had been collecting claims from automobile policies even if the patient being treated had health insurance. If the automobile insurer did not settle the claim quickly and the window lapsed on filing a claim with the health carrier, St. Luke’s often filed a lien against the patient directly.