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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. Im very happy for you, getting ready to go down that dirt road myself, and im praying for the same outcome, because it IS sometimes in the childs best interest to have visitation with grandparents. Thanks for sharing, needed to hear some positive posts for once.

  2. Been there 4 months with 1 paycheck what can i do

  3. our hoa has not communicated any thing that takes place in their "executive meetings" not executive session. They make decisions in these meetings, do not have an agenda, do not notify association memebers and do not keep general meetings minutes. They do not communicate info of any kind to the member, except annual meeting, nobody attends or votes because they think the board is self serving. They keep a deposit fee from club house rental for inspection after someone uses it, there is no inspection I know becausee I rented it, they did not disclose to members that board memebers would be keeping this money, I know it is only 10 dollars but still it is not their money, they hire from within the board for paid positions, no advertising and no request for bids from anyone else, I atteended last annual meeting, went into executive session to elect officers in that session the president brought up the motion to give the secretary a raise of course they all agreed they hired her in, then the minutes stated that a diffeerent board member motioned to give this raise. This board is very clickish and has done things anyway they pleased for over 5 years, what recourse to members have to make changes in the boards conduct

  4. Where may I find an attorney working Pro Bono? Many issues with divorce, my Disability, distribution of IRA's, property, money's and pressured into agreement by my attorney. Leaving me far less than 5% of all after 15 years of marriage. No money to appeal, disabled living on disability income. Attorney's decision brought forward to judge, no evidence ever to finalize divorce. Just 2 weeks ago. Please help.

  5. For the record no one could answer the equal protection / substantive due process challenge I issued in the first post below. The lawless and accountable only to power bureaucrats never did either. All who interface with the Indiana law examiners or JLAP be warned.

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