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Friday, January 15, 2021

Class Action Suit Targeting Cleveland Clinic's Billing Practices Gets Big Victory

Posted By on Fri, Jan 15, 2021 at 3:50 PM

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A Cuyahoga County Court of Common Pleas judge Thursday denied the Cleveland Clinic Foundation's motion to dismiss a potential class-action lawsuit targeting the hospital's billing practices.

Judge John P. O'Donnell ruled that the suit may go forward, and that the arguments advanced by the Clinic's legal team — basically, that certain Ohio consumer protection laws don't apply to the Clinic because of exemptions for transactions between physicians and patients — were faulty or unconvincing. 

Daniel Myers, attorney for plaintiff Amanda van Brakle, told Scene he was glad the case can move toward  a trial.

"Since this case started, more people have come forward with issues, and we've filed additional cases against other hospitals engaged in similar conduct," he wrote in an email. "If the case is ultimately successful, we look forward to hopefully getting hospitals to be transparent with pricing upfront, preventing many surprise medical bills, and requiring accurate medical billing for patients of Ohio hospitals."

The suit emerged after van Brakle underwent a radiology exam at a Lakewood Cleveland Clinic office in 2018. She was never provided an estimate for the procedure, and the partial payments that she submitted over time were not regularly and coherently applied to her balance. An initial lawsuit filed in October sought up to $5 million in damages and alleged that the Clinic's unfair billing practices created confusion, caused undue stress and resulted in the financial ruin of many patients.

The Clinic argued in its motion to dismiss that unlike goods and services which have a known price, the medical services it provided were dependent on a specific patient's needs, whether or not that patient had insurance, and the specific terms of the insurance plan.

But Judge O'Donnell refuted that line of argument. He ruled that radiology and imaging services, which are outpatient procedures and, at least in Van Brakle's case, were not administered by a physician, are "the very definition of a routine test." There was nothing preventing the Clinic from knowing the procedure's approximate cost and furnishing a written or oral estimate up front, regardless of van Brakle's insurance status.   

O'Donnell also agreed with county precedent in ruling that even though physicians are exempt from the Consumer Sales Practices Act, the hospitals they work for are not. You can read the full 12-page ruling below.

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