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Hospital wins on uninsured patients’ appeal of rates charged

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The Indiana Supreme Court ruled in favor of a hospital’s motion to dismiss a complaint brought by uninsured patients regarding the rates charged by the hospital, finding the patients’ complaint failed to state facts on which the trial court could have granted relief.

Abby Allen and Walter Moore brought a putative class-action complaint against Clarian Health Partners Inc. in 2010 on behalf of themselves and other uninsured recipients of Clarian’s services since May 2000. They claimed that the hospital breached its contract with them by charging unreasonable fees after they received medical treatment. Before receiving treatment, Allen and Moore signed the standard form of contract agreeing to pay their accounts, but the contracts didn’t specify a fee schedule. They were charged based on Clarian’s chargemaster rates.

The trial court granted Clarian’s – now Indiana University Health – motion to dismiss, but the Court of Appeals reversed in October 2011, finding the price for services rendered to be a missing and essential term of the contract.

But Justice Robert Rucker wrote that a contract doesn’t need to state a specific dollar amount for goods or services in order to be enforceable. He pointed out that the 3rd Circuit Court of Appeals has found that omitting a specific dollar amount is “the only practical way in which the obligations of the patient to pay can be set forth, given the fact that nobody yet knows just what condition the patient has, and what treatments will be necessary to remedy what ails him or her.”

The justices disagreed with the patients’ contention that their promise to pay “the account” for treatment is indefinite and therefore can’t constitute a price term for the hospital’s services.

“Many courts have addressed contracts similar to those of Patients’ and most have held that price terms in these contracts, while imprecise, are not sufficiently indefinite to justify imposition of a ‘reasonable’ price standard,” Rucker wrote in Abby Allen and Walter Moore v. Clarian Health Partners, Inc., 49S02-1203-CT-140.

The high court declined to extend Stanley v. Walker, 906 N.E.2d 852 (Ind. 2009), to actions for breach of contract and decided to align with courts that have recognized the uniqueness of the market for health care services delivered by hospitals.

By resolving the breach of contract claim, the justices didn’t rule on the patients’ declaratory judgment claim.

 

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  • er ok whatever
    We'll see this issue again. The hospitals cant just charge whatever they want. This ripoff will be challenged again and a more artful complaint will prevail.

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  1. The practitioners and judges who hail E-filing as the Saviour of the West need to contain their respective excitements. E-filing is federal court requires the practitioner to cram his motion practice into pigeonholes created by IT people. Compound motions or those seeking alternative relief are effectively barred, unless the practitioner wants to receive a tart note from some functionary admonishing about the "problem". E-filing is just another method by which courts and judges transfer their burden to practitioners, who are the really the only powerless components of the system. Of COURSE it is easier for the court to require all of its imput to conform to certain formats, but this imposition does NOT improve the quality of the practice of law and does NOT improve the ability of the practitioner to advocate for his client or to fashion pleadings that exactly conform to his client's best interests. And we should be very wary of the disingenuous pablum about the costs. The courts will find a way to stick it to the practitioner. Lake County is a VERY good example of this rapaciousness. Any one who does not believe this is invited to review the various special fees that system imposes upon practitioners- as practitioners- and upon each case ON TOP of the court costs normal in every case manually filed. Jurisprudence according to Aldous Huxley.

  2. Any attorneys who practice in federal court should be able to say the same as I can ... efiling is great. I have been doing it in fed court since it started way back. Pacer has its drawbacks, but the ability to hit an e-docket and pull up anything and everything onscreen is a huge plus for a litigator, eps the sole practitioner, who lacks a filing clerk and the paralegal support of large firms. Were I an Indiana attorney I would welcome this great step forward.

  3. Can we get full disclosure on lobbyist's payments to legislatures such as Mr Buck? AS long as there are idiots that are disrespectful of neighbors and intent on shooting fireworks every night, some kind of regulations are needed.

  4. I am the mother of the child in this case. My silence on the matter was due to the fact that I filed, both in Illinois and Indiana, child support cases. I even filed supporting documentation with the Indiana family law court. Not sure whether this information was provided to the court of appeals or not. Wish the case was done before moving to Indiana, because no matter what, there is NO WAY the state of Illinois would have allowed an appeal on a child support case!

  5. "No one is safe when the Legislature is in session."

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