ILNews

Judges rule against hospital in fee suit

Back to TopCommentsE-mailPrintBookmark and Share

Citing caselaw that goes back 120 years, the Indiana Court of Appeals reversed a Marion Superior judge’s dismissal of a complaint against a central Indiana hospital pursuant to Indiana Trial Rule 12(B)(6). The appellate court held that the plaintiffs’ complaint, which challenged the reasonableness of the fees the hospital charged the uninsured patients, states a claim for breach of contract.

Abby Allen and Walter Moore filed a lawsuit against Clarian Health Partners claiming Clarian breached its contract with them and other uninsured recipients by charging them unreasonable fees after receiving medical treatment at a Clarian medical center in Carmel. Before they were treated, both signed the standard form of contract agreeing to pay their accounts, but those contracts didn’t specify a price or fee schedule for the services to be provided. Neither Allen nor Moore had health insurance. They were charged based on Clarian’s “chargemaster” rates, and Allen’s bill was later submitted to a collection agency.

The plaintiffs aren’t asking for charges to be waived; they are asking  the judge to declare the chargemaster rates billed to uninsured patients to be unreasonable and unenforceable. The trial court granted Clarian’s motion to dismiss for failure to state a claim upon which relief can be granted and dismissed the complaint with prejudice.

Addressing several issues, including whether the contract was breached and if the contracts unambiguously required payment, the COA ruled in favor of the plaintiffs, finding because no price was specified in the contracts, Allen and Moore only agreed to pay a reasonable charge for Clarian’s services. The judges cited several cases dating back to 1888 to support their holding, including the recent Indiana Supreme Court decision Stanley v. Walker, 906 N.E.2d 852, 856-57 (Ind. 2009). They declined to consider foreign rulings that Clarian cited which found hospitals aren’t held to the same reasonableness standard in the interpretation of their contracts for medical services.

“Here, the contracts provided by Clarian make no direct or indirect reference to the chargemaster or any other fee schedule, and the price for services to be rendered is, therefore, a missing and essential term,” wrote Judge Edward Najam in Abby Allen and Walter Moore v. Clarian Health Partners, Inc., No. 49A02-1011-CT-1174. “Hence, it is well settled under Indiana law that a reasonable fee is implied. Consistent with that law, Allen and Moore alleged in their complaint that Clarian charged them an unreasonable price. That allegation, if true, would constitute a breach of contract.”

The COA also declined to hold that Allen and Moore agreed to pay whatever amount Clarian charged, as that would be an unreasonable, if not absurd, interpretation of the contract, wrote the judge. The court remanded for further proceedings.
 

ADVERTISEMENT

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in Indiana Lawyer editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT
Subscribe to Indiana Lawyer
  1. This sure is not what most who value good governance consider the Rule of Law to entail: "In a letter dated March 2, which Brizzi forwarded to IBJ, the commission dismissed the grievance “on grounds that there is not reasonable cause to believe that you are guilty of misconduct.”" Yet two month later reasonable cause does exist? (Or is the commission forging ahead, the need for reasonable belief be damned? -- A seeming violation of the Rules of Profession Ethics on the part of the commission) Could the rule of law theory cause one to believe that an explanation is in order? Could it be that Hoosier attorneys live under Imperial Law (which is also a t-word that rhymes with infamy) in which the Platonic guardians can do no wrong and never owe the plebeian class any explanation for their powerful actions. (Might makes it right?) Could this be a case of politics directing the commission, as celebrated IU Mauer Professor (the late) Patrick Baude warned was happening 20 years ago in his controversial (whisteblowing) ethics lecture on a quite similar topic: http://www.repository.law.indiana.edu/cgi/viewcontent.cgi?article=1498&context=ilj

  2. I have a case presently pending cert review before the SCOTUS that reveals just how Indiana regulates the bar. I have been denied licensure for life for holding the wrong views and questioning the grand inquisitors as to their duties as to state and federal constitutional due process. True story: https://www.scribd.com/doc/299040839/2016Petitionforcert-to-SCOTUS Shorter, Amici brief serving to frame issue as misuse of govt licensure: https://www.scribd.com/doc/312841269/Thomas-More-Society-Amicus-Brown-v-Ind-Bd-of-Law-Examiners

  3. Here's an idea...how about we MORE heavily regulate the law schools to reduce the surplus of graduates, driving starting salaries up for those new grads, so that we can all pay our insane amount of student loans off in a reasonable amount of time and then be able to afford to do pro bono & low-fee work? I've got friends in other industries, radiology for example, and their schools accept a very limited number of students so there will never be a glut of new grads and everyone's pay stays high. For example, my radiologist friend's school accepted just six new students per year.

  4. I totally agree with John Smith.

  5. An idea that would harm the public good which is protected by licensing. Might as well abolish doctor and health care professions licensing too. Ridiculous. Unrealistic. Would open the floodgates of mischief and abuse. Even veteranarians are licensed. How has deregulation served the public good in banking, for example? Enough ideology already!

ADVERTISEMENT