When Patients Are Feeling Low, Envision Goes High on Surprise Medical Bills

Jul 23, 2019 | Blog Post, Private Equity

Envision Healthcare Corp., the parent company of EmCare which is notorious for exorbitant surprise medical bills, is now facing a class-action lawsuit from several Texas patients who were on the receiving end of unfair and excessive out-of-network charges. The lawsuit, highlighted in theNashville Business Journal, is not the first for Envision. “In 2017, thecompany settled a case with the Department of Justice involving EmCare, which was accused of overcharging for emergency room visits at hospitals affiliated with Health Management Associates. Envision settled that case for $31 million.” Highlights from the article are included below:

  • “A class-action lawsuit accusing Envision of issuing large surprisemedical bills to patients who thought they were receiving services from an in-network physician has been filed against the Nashville-based company and its EmCare Inc. subsidiary. The lawsuit seeks monetary damages exceeding $5 million, according to the filing made July 9 in the U.S. Southern District Court of Texas.”
  • “Envision was Middle Tennessee’s third-largest publicly traded health care company, with $7.8 billion of revenue in 2017, before it was sold to private-equity firm KKR for $9.9 billion last year. The company employs more than 25,000 clinicians in 45 states.”
  • “The lawsuit, filed by Houston resident Sandeep Kaur and on behalf of other Texas Envision patients, claims patients across the country have been given large surprise medical bills after seeking treatment at hospitals inside their insurance provider’s network, only to find out later they were treated by an out-of-network physician.”
  • “In November 2016, the plaintiff alleges she went to the emergency department at Cypress Fairbanks Medical Center Hospital after sustaining a head injury, according to the filing. The plaintiff claims the hospital was in her insurance network and she expected the cost of the visit not to exceed her emergency room copay of $100. Weeks later she received a bill totaling nearly $2,900 and learned that while the hospital was in-network, the physician who treated her was not.”
  • “The lawsuit claims the plaintiff’s situation at EmCare is not unique, alleging that in the 194 hospitals EmCare staffed between 2011 and 2015, 62 percent of patients were billed out-of-network. It alleges that when EmCare took over the management of emergency departments, out-of-network rates raised by more than 81 percent.”
  • “’The old saying is that ‘everything’s bigger in Texas’ — and, unfortunately, that appears to be true when it comes to the problem of surprise billing,’ the lawsuit alleges. ‘There are more than three hundred hospitals [in Texas] that do not have a single in-network emergency department physician for one or more of the insurers covering the hospital.’”
  • “Envision couldn’t immediately be reached for comment.”