LawyersUSA

Uninsured patients can't sue a hospital for charging them more than insured patients or those covered by Medicare and Medicaid, the 3rd Circuit has ruled.

The hospital was part of a not-for-profit health care system that accepted discounted payments from various payers, including Medicare and Medicaid. It maintained a master list of charges for services. These varied for a number of insurers that negotiated rates the hospital would charge their insureds, and for other categories of patients.

An uninsured patient was charged $3,400 for services he received at the hospital, which was more that what the hospital charged under Medicare, Medicaid or the negotiated rates with insurers. But the patient signed a form guaranteeing that he would pay for "all charges" for services rendered.

The patient sued the hospital, arguing the higher charges he paid were discriminatory, unreasonable and breached his contract.

The court disagreed.

"While [the patient's] contentions have facial persuasiveness, they fail to take into account the peculiar circumstances of hospitals, such as [the defendant], and the bearing these circumstances have upon the interpretation of contracts between a patient and the hospital," the court said.

Here, "the form contract employed by [the hospital] is the only way to communicate to a patient the nature of his or her financial obligations to the hospital. Furthermore, 'it is incongruous to assert that [a hospital] breached the contract by fully performing its obligation to provide medical treatment to the plaintiff and then sending [him] [an] invoice for charges not covered by insurance.'"

U.S. Court of Appeals, 3rd Circuit. DiCarlo v. St. Mary Hospital, No. 06-3579. June 24, 2008. Lawyers USA No. 99310240. Click here for the full text of this opinion.