/Couple sues north Mississippi hospital for alleged balance billing

Couple sues north Mississippi hospital for alleged balance billing

A state law from 2013 makes balance billing illegal. A 2013 state law makes it illegal to bill balance. If a hospital bills a patient $10,000, the hospital will pay $5,000 to the hospital. The hospital cannot then collect the $5,000 remaining. Although balance billing is against the law in Mississippi, it still occurs as many people are not aware of the state’s laws. According to the lawsuit, Chastity Woods required dozens of non-elective treatments in 2017, including blood transfusions and iron transfusions. These treatments were provided by North Mississippi Medical Center (NMMC), Tupelo, and other local clinics owned by North Mississippi Health Services, Inc. In 2018, Chastity received payment from Chastity’s insurer Health Cost Solutions. The providers then returned to the Woods to demand almost $50,000 in additional payments. The Woods, unaware of Mississippi’s ban against balance billing, accepted a tax time deal from debt collectors in March 2019, which would reduce their bills by 20%. The suit states that they then paid their bills by getting a home equity loan. Woods claim that the debt collector returned in October 2019 to demand $8,936.05 more, even though the Woods had already paid $42,000 to the hospital debt collector. Woods claim that debt collectors harassed them throughout their legal process, which culminated in them filing a lawsuit in February 2020. Mississippi Today spoke with Chastity but she declined to comment. Their attorney was not available for comment. Bruce J. Toppin is the chief legal officer of North Mississippi Health Services. He told Mississippi Today that the company doesn’t comment on any pending litigation. According to Roy Mitchell (executive director of the Mississippi Health Advocacy Program), balance billing is illegal in Mississippi. However, some hospitals have not updated their business models since then. “We (Mississippi), have the highest rate in medical debt in the nation.” Mitchell stated that we have done so for many years. The ban on balance billing has little teeth. Mike Chaney, Insurance Commissioner, and Lynn Fitch, Attorney General claim they don’t have the legal enforcement authority to sue hospitals for breaking the law. Patients like the Woods are left with no choice but to file expensive and lengthy lawsuits. In order to strengthen balance billing law in 2019, a legislative effort would have required that the attorney general’s Office enforce the law and create binding arbitration to settle any balance billing disputes between patients and providers. The bill was not passed by the committee, even though it was written by Gary Chism (then House Insurance Chairman), Chism stated to Mississippi Today that the bill was opposed by lawmakers who were also doctors. Chism stated that “they want to be in a position to get their money.” Attorneys for the hospital claim that Chastity’s insurance plan does not cover NMMC. This means that the hospital would have received a greater reimbursement if Stanley had used her insurance. The attorneys stated that the Woods chose to go cheap and ended up paying significantly more out-of-pocket expenses. Because Stanley’s state employee plan had a higher deductible, the Woods chose Chastity’s Health Cost Solutions plan. However, Mississippi’s antibalance billing does not distinguish between different types of networks. According to law, if the provider accepts payment form the insurer, “the payment shall constitute payment in full to that provider,” meaning that they can’t bill or collect any additional amount from the insured besides the deductible, coinsurance or copayment. The Woods lawyers argued that if providers felt that the reimbursement rates offered to Chastity’s insurance were too low, they could have declined to provide non-emergency treatment, or suggested that the Woods look for another payment method. According to the lawsuit, NMMC received at least 48 payments from Chastity’s insurer at 140% of what Medicare would have paid. The Woods seek a permanent injunction to stop NMMC from issuing or attempting balance bills.