The Indiana Supreme Court heard argument on May 10, 2012, from two uninsured patients that claimed a non-profit hospital overbilled them. Specifically, they claimed the Hospital charged them more than insured patients for the same treatment. Both patients acknowledged signing contracts for payment in which they agreed to pay the Hospital’s bill if the “account is not paid by a private or governmental insurance carrier.” In response to the Hospital demand for payment, the patients argued, based on a long standing line of Indiana case law, that; where no specific price is specified in the contract for services, the law implies a promise to pay only a “reasonable charge” for the services. The patients argued unless the charge is specified in advance of the treatment a “reasonable charge” would be based on what is commonly charged to the majority of other patients in the community.
In turn, the Hospital presented argument that the Hospital has the same right as any other business to give discounts to customers who have demonstrated prompt and routine payment. In addition, the Hospital’s argument is based on the argument that it is difficult if not impossible to disclose the cost of medical services prior to treatment as the plan of care often changes once the patient’s care is commenced.
This decision from the Court will not affect for-profit hospitals or anyone who treated after 2010, as the Patient Protection and Affordable Care Act now requires all non-profit Hospitals to provide an across the board discount.
The Indiana Supreme Court will likely issue an opinion in the next few months.
Should you have any questions, please contact your regular Hall Render attorney.