TeamHealth Hit with Class-Action Lawsuit Accusing it of Hospital and ER Billing Fraud
SAN FRANCISCO – A class-action lawsuit filed against TeamHealth details widespread fraudulent medical billing practices by the hospital contractor, and accuses it of skirting state laws banning the corporate practice of medicine, according to attorneys at Hagens Berman and Justice Catalyst Law.
The lawsuit filed in the U.S. District Court for the Northern District of California on July 10, 2020 states that TeamHealth has placed private profits over public health by creating an enterprise with the sole purpose of “profiting from patients’ health emergencies,” and has engaged in fraudulent billing rates and charges.
“TeamHealth controls the terms of its physicians’ employment, all physician staffing decisions, and, most importantly, all the rates its physicians and practice groups charge patients,” the lawsuit reads. “The successful goal of this enterprise is to maximize corporate profits while avoiding state bans on the corporate practice of medicine.”
“Most states bar the corporate practice of medicine, and for good reason. TeamHealth is exactly the kind of pseudo-health conglomerate state laws are designed to stop,” said Steve Berman, managing partner of Hagens Berman and attorney representing the proposed class of individuals. “Its sole role has been to take advantage of those who are most vulnerable and in need – those experiencing health emergencies.”
“TeamHealth’s name is the exact and utter antithesis of its role in the health care sector.”
The private equity-funded corporation contracts with hospitals to take over their emergency, critical care, radiology and anesthesiology departments, supplying them with doctors and other medical professionals as well as running their administrative functions. In 2016, TeamHealth boasted that it controlled 17 percent of the emergency medicine market in the United States.
The lawsuit accuses Team Health Holdings of violating the Racketeer Influenced and Corrupt Organizations Act through this enterprise, including mail and wire fraud, as well as violating state consumer protection laws.
TeamHealth’s Fraudulent Billing Explained
From a patient’s perspective, TeamHealth medical professionals appear to be employed by the hospitals in which they operate. Their staff work within the hospital and do not wear uniforms or other apparel that would identify them as non-hospital staff. Nonetheless, TeamHealth is a separate entity from the hospitals with which it contracts, according to attorneys. Patients only learn of this reality upon receipt of a separate bill from TeamHealth.
The lawsuit states that TeamHealth sends fraudulent bills to patients for the care they received from TeamHealth physicians. These bills contain grossly inflated charges for medical care—charges that TeamHealth is not legally entitled to recover. And TeamHealth knows it.
“Patients sign no paperwork with TeamHealth—let alone agree on price. Yet, the TeamHealth
Fraudulent Billing Enterprise pursues patients ruthlessly for far more than the reasonable value of their services, through a medical debt collector that is a TeamHealth subsidiary. The TeamHealth Fraudulent Billing Enterprise has sued thousands of patients in the last few years, including patients who would qualify for free care and reduced rates under hospitals’ ‘charity care’ programs,” the lawsuit states.
As hospitals have reported, “TeamHealth ER physicians expect to be paid nearly three times the median rate for in-network physicians at participating hospitals, and their billed charges are even higher, at more than four times the median rate,” the complaint states.
“While TeamHealth bills and sues its own patients into debt and duress, 60 percent of Americans cannot afford to pay an unexpected medical bill of more than $1,000 and 66.5 percent of all bankruptcies in the United States are due in whole or in part to medical debt,” Berman said.
“Americans should not have to risk financial ruin whenever they have a medical emergency,” said Craig Briskin, Senior Counsel at Justice Catalyst Law and an attorney representing plaintiff. “This suit seeks nothing less than returning common sense and the rule of law to medical billing.”
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About Hagens Berman
Hagens Berman Sobol Shapiro LLP is a consumer-rights class-action law firm with nine offices across the country. The firm’s tenacious drive for plaintiffs’ rights has earned it numerous national accolades, awards and titles of “Most Feared Plaintiff’s Firm,” and MVPs and Trailblazers of class-action law. More about the law firm and its successes can be found at www.hbsslaw.com. Follow the firm for updates and news at @ClassActionLaw.
About Justice Catalyst Law
Justice Catalyst Law is a nonprofit law firm that focuses on combatting social and economic injustice, working nationally to support cases and policy work in the fields of antitrust, consumer protection, employment discrimination and civil rights. More about Justice Catalyst Law can be found at https://justicecatalyst.org/.