Georgia Supreme Court Rejects Medical Overbilling Class Action

Many auto accident victims struggle not only to recover from their physical injuries, but also to deal with excessive medical bills. Georgia hospitals frequently file “liens” against accident victims’ potential personal injury claims in order to ensure their bills get paid. But the actual amount of these bills can vary wildly, especially when the victim lacks health insurance.

Bowden v. Medical Center, Inc.

In 2011, an uninsured woman named Danielle Bowden was injured in an auto accident. She subsequently received care at The Medical Center, Inc., (TMC) in Muscogee County. Bowden had no health insurance at the time, and TMC billed her over $21,000 for her treatment. TMC then filed a hospital lien against Bowden’s potential recovery against the other driver who caused her accident.

The other driver’s insurance company offered to settle for the full amount of the policy, which was $25,000, but Bowden would not agree, as she believed TMC was seeking to recover excessive charges via its lien. This prompted Bowden to file a lawsuit against TMC, accusing it of fraud, negligent misrepresentation, and racketeering. Bowden later sought to add additional plaintiffs–other former TMC patients–and turn the case into a class action over the hospital’s alleged overbilling practices.

Although a trial court granted class certification, the Georgia Supreme Court reversed. In a June 29 opinion authored by Chief Justice Harold D. Melton, the Court said Bowden’s claims did not satisfy the legal requirements for certifying a class action. As a general rule, Melton said, plaintiffs with different claims are expected to pursue them separately. Class certification is only appropriate when there are “questions of law or fact common to the class.”

That was not the case here, Melton said. Bowden’s proposed class would include “both insured and uninsured people, those whose liens were removed, and those who never settled their lawsuits and thus paid nothing.” The lack of “commonality” between members of this “overbroad” group would require “individualized inquiries and answers,” which would defeat the entire purpose of a class action.

Indeed, even if Bowden limited the class to uninsured patients subject to an active lien, Melton said there would still be a lack of commonality. This is because the thrust of Bowden’s claim is that TMC assessed “unreasonable” charges for the post-accident care that she received. It would therefore require an individualized assessment of each potential plaintiff’s claim to determine if they were also charged an unreasonable amount for their medical care. Put another way, Melton said, it would be impossible for a jury to “come up with an as-yet-to-be-determined formula for arriving at a reasonable charge.”

Melton also rejected the substance of Bowden’s claims that TMC violated Georgia’s hospital lien laws by making unreasonable charges in the first place. TMC relied on its own base or “chargemaster” rates in billing Bowden for her care. Melton said filing a lien based on these rates, which reflected “true market considerations such as hospital costs,” was not “fraudulent” under Georgia law.

Contact Information