EmCare Class Action Lawsuit Alleges Unfair Billing Strategies

An EmCare class action lawsuit has been filed alleging that the healthcare company unfairly charges out of network costs at an in-network emergency department.

Lead plaintiff Renee MacLaughan Bozarth has filed a class action lawsuit against EmCare, Envision, and EDS-I, alleging that she was charged out of network rates for treatment at an in-network emergency room due to unfair business practices.

In the EmCare class action lawsuit, Bozarth seeks to represent a statewide Class of individuals in California who were provided emergency medical services at an in-network emergency department but were seen by an out of network provider employed by EmCare, resulting in surprise out of network medical bills.

According to her EmCare class action lawsuit, Bozarth went to the emergency room In August 2016 after experiencing abdominal pain. She says she went to a hospital that was considered in the network under her insurance plan. She was evaluated and told she needed to have her gallbladder removed within 30 days.

Before she was able to have an evaluation by her physician, she claims, she again had severe pain in her abdomen. She returned to the emergency room and was told she had to have her gallbladder removed immediately. She was admitted to the hospital and had her gallbladder removed.

Several months after her surgery, Bozarth claims she was billed for a shocking amount of $4,000. She says she did not know the hospital she went through had their emergency room was staffed by EmCare. Although her surgery was covered at an in-network rate, her treatment and care by the emergency room doctor were allegedly covered at an out of network rate. Bozarth argues that she was not told her emergency care would be out of network, and she allegedly did not have the option to see an in-network provider.

EmCare, a subsidiary of Envision, contracts with hospitals to staff and manage emergency departments. The company allegedly claims it can improve emergency department management and generate greater profits. EmCare recruits doctors and provides staff in emergency rooms to relieve hospitals of the stress of running an emergency room.

The EmCare class action lawsuit argues that EmCare purposefully hires out of network doctors to in-network emergency rooms so that patients will be charged more, and the hospitals will make more money. Bozarth also alleges that EmCare bills their services at the highest paying billing code to maximize profits.

The EmCare class action lawsuit argues that EmCare employees engage in unfair business practices and take advantage of patients in emergency situations. “Patients receiving emergency care are unable to contract for, let alone negotiate, the terms surrounding the provision of possible life-saving care,” the EmCare class action lawsuit states.

Bozarth accuses EmCare of violating various California business laws and breaching contract. The EmCare class action lawsuit seeks a trial by jury, damages, restitution, court costs, and attorneys’ fees.

The EmCare Class Action Lawsuit is Bozarth, et al. v. Envision Healthcare Corporation, et al., Case No. 5:17-cv-01935-FMO-SHK, in the U.S. District Court for the Central District of California.