Judge George C. Hanks, Jr. of the U.S. District Court for the Southern District of Texas has granted preliminary approval of a proposed class action settlement in this surprise billing consumer litigation. Class Members, who were treated in emergency departments by physician practices affiliated with Defendants, may obtain monetary relief in two forms. First, eligible Class Members who submit valid claims (“Claimants”) may obtain write-offs of any outstanding balances allegedly owed to Defendants; that is, Defendants will write-off the difference between Defendants’ billed rates and the “Allowable Charge(s)” that the Class Member’s health insurance plan determined, pursuant to federal regulations, represents reasonable reimbursement. Second, Defendants will refund any payments made in excess of the Allowable Charge(s), including payments made after Defendants sold or otherwise transferred interest in the contested debt to a collection agency, to Claimants.
The Settlement also provides nonmonetary benefits for the Class and the larger public through provisions requiring Defendants to request, in writing, that any hospital they contract with make certain specified disclosures, which would alert patients to the possibility of receiving out-of-network emergency department physician services in an in-network emergency department and allow patients to determine whether the emergency department physicians are in fact out-of-network. In sum, the Settlement enables those injured by Defendants’ alleged unfair and deceptive business practices to make a complete recovery and requires Defendants take steps to prevent consumers from being misled in the future.