Colorado Woman Wins Fight Against Crazy Hospital Bill

Colorado Supreme Court rules in favor of Lisa French
By Kate Seamons,  Newser Staff
Posted May 19, 2022 7:45 PM CDT
She Was Told It Was a $1K Surgery, Got Billed $304K
   (Getty Images / jittawit.21)

(Newser) – Lisa French may finally be able to wash her hands of the $228,000 hospital bill that's been hanging over her head since 2014, thanks to a Monday ruling by the Colorado Supreme Court. The Denver Post has the story of the bill, which is tied to two back surgeries French underwent at St. Anthony North Health Campus. In advance of the procedures, a hospital employee misread French's insurance card and quoted an out-of-pocket price of $1,337; she signed a standard contract saying she would pay "all charges of the hospital" related to her care. Thing was, the hospital was out of network, not in, as the employee believed.

As such, the hospital billed $303,709 for the surgeries, which the Fort Morgan Times notes is 227 times the estimate she was given. Insurance covered about $74,000, leaving her with $228,000 to pay. She lodged a civil case. The Post gets into the ins and outs of the "chargemaster"—at the time a secretive roster of the hospital's sticker prices for its procedures. As of 2019, hospitals must make those prices public, but that wasn't the case then, and French wasn't told about or shown the chargemaster. The state Supreme Court justices ruled that French "assuredly could not assent to terms about which she had no knowledge and which were never disclosed to her."

They swung at chargemasters in general, calling them "arbitrary" and generally untethered to a hospital's real costs, but rather "inflated rates set to produce a targeted amount of profit for the hospitals after factoring in discounts negotiated with private and governmental insurers." The Colorado Court of Appeals had earlier ruled in the hospital's favor, saying that because hospitals can't always anticipate exactly what a patient will need, they're unable to set a locked-in price, making "all charges" sufficiently precise. Per the Fort Morgan Times, the hospital had argued that it fell to the patient, not the hospital, to understand their insurance coverage. The upshot of the ruling is that all French is on the hook for is $767. Her lawyer describes her as "very happy with the result." (Read more health insurance stories.)

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