Judge Ciaffa, who is probably one of the most consumer oriented judges on the bench – and has good reason to be – has written another blockbuster decision. This time, instead of attacking the assignees of credit card debt – I can never get enough of those decisions – he is going after those medical providers who seek judgments against uninsured patients. This is an excellent decision, and I hope the Appellate Term and Appellate Division adopt it.
Nassau Anesthesia Assoc. PC v Chin, 2011 NY Slip Op 21178 (Dis. Ct. Nassau Co. 2011)
“As the Court of Appeals recognized in the context of a dispute involving an insured patient’s co-insurance obligation, private insurers may be able to obtain “very substantial discount[s]” from medical providers for a variety of reasons, i.e. “volume of payments, promptness of payment, assurance of payment.” See Flushing Hosp. v. Woytisek, 41 NY2d 1081, 1082 (1977).
Nevertheless, in cases, like this, where a medical provider seeks a monetary judgment against an uninsured individual, the Court cannot ignore the realities of today’s healthcare marketplace. At the Court’s request, plaintiff provided the Court with information comparing the amounts charged to uninsured persons (such as defendant) and the amounts plaintiff would have accepted from major private insurers or the federal government under Medicare and Medicaid. The differences in payments are striking.
According to plaintiff’s billing supervisor, “[a] person without insurance, such as the Defendant, . . . would pay $8,675.00″ for plaintiff’s anesthesia services. In contrast, if defendant had been covered by Blue Cross Blue Shield, United Healthcare, or Vytra, plaintiff would have been paid between $5,208.01 (Blue Cross Blue Shield) and $6,970.00 (United Healthcare). Medicare, in turn, would have paid plaintiff only $1,605.29. And if defendant were covered by Medicard, plaintiff would have received just $797.50.”
