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Judges rule against hospital in fee suit

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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.
 

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  1. Video pen? Nice work, "JW"! Let this be a lesson and a caution to all disgruntled ex-spouses (or soon-to-be ex-spouses) . . . you may think that altercation is going to get you some satisfaction . . . it will not.

  2. First comment on this thread is a fitting final comment on this thread, as that the MCBA never answered Duncan's fine question, and now even Eric Holder agrees that the MCBA was in material error as to the facts: "I don't get it" from Duncan December 1, 2014 5:10 PM "The Grand Jury met for 25 days and heard 70 hours of testimony according to this article and they made a decision that no crime occurred. On what basis does the MCBA conclude that their decision was "unjust"? What special knowledge or evidence does the MCBA have that the Grand Jury hearing this matter was unaware of? The system that we as lawyers are sworn to uphold made a decision that there was insufficient proof that officer committed a crime. How can any of us say we know better what was right than the jury that actually heard all of the the evidence in this case."

  3. wow is this a bunch of bs! i know the facts!

  4. MCBA .... time for a new release about your entire membership (or is it just the alter ego) being "saddened and disappointed" in the failure to lynch a police officer protecting himself in the line of duty. But this time against Eric Holder and the Federal Bureau of Investigation: "WASHINGTON — Justice Department lawyers will recommend that no civil rights charges be brought against the police officer who fatally shot an unarmed teenager in Ferguson, Mo., after an F.B.I. investigation found no evidence to support charges, law enforcement officials said Wednesday." http://www.nytimes.com/2015/01/22/us/justice-department-ferguson-civil-rights-darren-wilson.html?ref=us&_r=0

  5. Dr wail asfour lives 3 hours from the hospital,where if he gets an emergency at least he needs three hours,while even if he is on call he should be in a location where it gives him max 10 minutes to be beside the patient,they get paid double on their on call days ,where look how they handle it,so if the death of the patient occurs on weekend and these doctors still repeat same pattern such issue should be raised,they should be closer to the patient.on other hand if all the death occured on the absence of the Dr and the nurses handle it,the nurses should get trained how to function appearntly they not that good,if the Dr lives 3 hours far from the hospital on his call days he should sleep in the hospital

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