Following federal protections that shielded patients from surprise medical bills, providers are now pursuing employers directly to recover arbitrated payouts. National air ambulance operator PHI Health has taken the lead, seeking tens of millions of dollars from varied plan sponsors ranging from regional contractors to corporate giants like Amazon and Walmart. Georgetown University researchers calculate that these elevated arbitration awards have already added approximately $20 billion in expenses to the broader health system. Facing protracted court actions, employers must navigate escalating coverage costs and legal fees.
Key points
Health providers are shifting litigation directly toward employers when health insurance…: Health providers are shifting litigation directly toward employers when health insurance plans delay or fail to settle arbitrated out-of-network claims.
Mounting legal battles over unresolved arbitration awards threaten to inflate operational…: Mounting legal battles over unresolved arbitration awards threaten to inflate operational expenses and health coverage premiums for plan sponsors.
Some provider lawsuits utilize placeholder corporate names to sustain legal pressure even…: Some provider lawsuits utilize placeholder corporate names to sustain legal pressure even when an employee's exact plan sponsor remains unconfirmed.
Sources checked by our analysis pipeline: 1
This past August, Joe Hancock, a Kentucky plumbing and heating contractor, opened a just-delivered box packed with hundreds of sheets of paper. Leafing through them, he read seven words no small business owner wants to see: “A lawsuit has been filed against you.”
The complaint, from air ambulance firm PHI Health, claimed Hancock was on the hook for almost $27,000 in medical helicopter bills. They were tied to one of his now-retired employees, who needed an emergency flight after a heart attack.
Hancock, who owns Whitehead-Hancock Plumbing, Heating & Cooling, a family-run business in Frankfort, Ky., that has been around for more than a century, didn’t understand why he was being roped into a lawsuit that featured 31 other companies — for medical charges he was never aware of.
“I was terrified,” Hancock said. “I was like, ‘What in the hell is going on here?’”
He’s not alone. The PHI lawsuit highlights an evolving tactic by health care providers in a raging battle over out-of-network bills. Previously, providers targeted health insurance companies to pay outstanding amounts that were awarded through…
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