$220M Settlement Reached in X-Ray Billing Class Action Lawsuit

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According to court documents filed last week in Florida federal court, a settlement worth $220 million has been proposed in a class action lawsuit over allegations Florida hospitals affiliated with HCA Healthcare Inc. overcharged patients with personal injury protection (PIP) coverage for X-rays and CT scans.

Plaintiffs Marisela Herrera and Nicolas Acosta initially filed the medical billing class action lawsuit in August 2014, alleging HCA-affiliated hospitals in Florida charged unreasonable rates for radiological services to emergency room patients who were covered by Florida PIP insurance.

In Florida, car owners are reportedly required to carry $10,000 worth of PIP insurance. Typically, the PIP insurance will pay 80 percent and the driver or passenger will pay 20 percent.

According to the Florida PIP insurance class action lawsuit, the HCA-affiliated hospitals caused them to pay more than 20 percent and the charges often surpassed the $10,000 PIP limit, reaching into the patients’ deductibles or forcing them to pay out-of-pocket for their medical expenses.

Florida law requires hospitals that are treating patients who are covered by PIP to only charge a “reasonable amount” for medical services, the medical billing class action lawsuit says. The plaintiffs claim that Florida HCA-affiliated hospitals charged PIP patients far more than they charged other patients for emergency radiological services.

Herrera and Acosta were each allegedly charged more than $6,000 for X-rays and CT scans when they visited an HCA-affiliated facility after being injured in car accidents. In comparison, Medicaid’s reimbursement rate is a couple hundred dollars and HCA’s rate tier for uninsured patients is a few thousand dollars, the plaintiffs allege.

The parties began mediation in March and reached a proposed class action settlement worth $220 million in discounts on future medical services for Class Members.

The proposed Class includes anyone who receives medical services in the emergency department of a Florida HCA-affiliated hospital until four years after the effective date of the settlement, whose Florida PIP insurance pays for a portion of the medical service, who lack secondary insurance applicable to the medical services (or for whom a personal injury settlement related to the accident caused the person to receive the applicable medical services), and who have a remaining balance after their Florida PIP insurance pays the hospital.

During this four-year period, the Florida HCA-affiliated hospitals will apply the PIP discount to eligible Class Members. The discount will reportedly be applied to the Class Members’ bills after their Florida PIP insurance pays the hospital.

On Friday, the plaintiffs asked a Florida federal judge to certify the proposed Class and to preliminary approve the Florida PIP coverage class action settlement.

Top Class Actions will post updates to this class action settlement as they become available. For the latest updates, keep checking TopClassActions.com or sign up for our free newsletter. You can also receive notifications when this article is updated by using your free Top Class Actions account and clicking the “Follow Article” button at the top of the post.

The plaintiffs are represented by Theodore Leopold, Diana Martin, Andrew Friedman and Douglas McNamara of Cohen Milstein Sellers & Toll PLLC.

The Florida PIP X-Ray Billing Class Action Lawsuit is Marisela Herrera, et al. v. JFK Medical Center Ltd., et al., Case No. 8:14-cv-02327, in the U.S. District Court for the Middle District of Florida.

UPDATE: November 2018, the JFK Medical Center x-ray billing class action settlement is now open. Click here to learn more.