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Patient sues Richland hospital over claims of deceptive ‘hidden fees’ for emergency care

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Matthew P. Carlson, DO, as he walks you through the different levels of care available at Good Shepherd Health Care System.

A patient at Kadlec Regional Medical Center has filed a lawsuit after being charged what he said was a hidden fee for going to the emergency room.

Kadlec said Thursday that the lawsuit is without merit.

Stephen Bradford has asked the court to certify the lawsuit as a class action case to include any patient charged an emergency room fee on top of specific charges for the treatments and services.

The case would include patients treated at Kadlec’s emergency rooms in Richland or Kennewick in the last four years.

The lawsuit, which has bounced between federal court and Benton County Superior Court, says Kadlec charges emergency department patients a fee ranging from $257 for “Level 1” care to $2,437 for “Level 5” care.

The fee is calculated after the patient is released and is based on a hospital formula that is not disclosed, the lawsuit said.

The lawsuit alleges that the fee is unfair, deceptive and unlawful.

It says the fee is not disclosed when a patient arrives at the emergency room.

Knowing there will be a “surcharge” for the emergency room could be a substantial factor in a patient’s deciding to stay for treatment or to seek less costly care elsewhere or to skip treatment, the lawsuit said.

Kadlec said in its initial response filed in U.S. District Court that it does not bill “surcharges,” but it does charge “facility fees.”

Surcharge vs. facility fee

“The facility fee for the emergency room is how a hospital gets paid to have an emergency room and the services that are available 24/7,” said Beth Zborowski, senior vice president at the Washington State Hospital Association.

Kadlec Tower Expansion.JPG
A patient has sued Kadlec Regional Medical Center in Richland, claiming the hospital charges hidden fee for using its emergency room. Sarah Gordon Tri-City Herald

It covers costs such as staffing, equipment and generally keeping the doors open whether there are 40 patients or two, she said.

Nearly every hospital emergency room in the nation charges a facility fee, Zborowski said.

Like Kadlec, most charge on a scale with five levels based on the amount of services, the resources needed and the time to treat, she said.

The charge is separate from charges for physicians and laboratory and other tests.

Kadlec said in a statement Thursday that it is proud of our “longstanding practice of providing patients with all the information they need to make informed decisions about their care.”

“We are committed to our mission of providing safe, compassionate care, and are confident in our patient financial services,” it said.

Hospital “hidden fee” on its website

The lawsuit said that all emergency room patients are given a consent form to sign at the emergency room, but it lacks any meaningful pricing information. It makes no mention of specific pricing, including the fee for using the emergency room.

The fee also is not disclosed on Kadlec’s website, on signs at the emergency room or during the in-person registration process, the lawsuit said.

Kadlec denied allegations that fees were hidden, according to in its initial response to the lawsuit filed in court.

The fee schedule is posted on Kadlec’s website at bit.ly/KadlecPricing, Zborowski pointed out.

The federal Emergency Medical Treatment and Labor Act limits what hospitals may tell patients when they show up for treatment at an emergency room, Zborowski said.

“Hospitals are not allowed to talk specific charges because it might discourage (patients) from obtaining emergency care,” which would violate the federal law, she said.

Outpatient services reduce costs

When Bradford went to one of Kadlec’s emergency departments in April 2017, he was billed $7, 845, which included a Level 4 emergency room fee of $1,425. The lawsuit did not disclose the reason for the emergency room visit or treatment given.

The itemized bill listed the charge only as “HC ED Level 4.” It was one of 19 charges on the bill, according to the lawsuit.

Bradford says he should only be required to pay charges for specific services rendered.

Kadlec said that it gave Bradford a 30 percent discount on it emergency department visit because he was paying himself rather than relying on insurance.

That reduced his bill from $7,845 to $5,131. He still owes $2,105, which includes interest, Kadlec said in court documents.

Bradford also visited the emergency room about seven months later and again received a 30 percent self-pay discount on a bill that was initially $4,195. He still $3,043 for the visit, which includes interest, according to Kadlec.

Zborowski said her advice is to go to an outpatient clinic such as those at drug stores if minor care is needed to avoid the facility fee charged by hospital emergency rooms.

“It is what allows a hospital to maintain services for when someone has a true emergency,” she said.

The lawsuit was initially filed in Benton County Superior Court and then moved to federal court by Kadlec.

Bradford ‘s attorneys asked to have the case moved back to Benton County Superior Court, which Kadlec did not oppose.

On June 6, U.S. Judge Sal Mendoza Jr. ordered the case be returned to Benton County.

Senior staff writer Annette Cary covers Hanford, energy, the environment, science and health for the Tri-City Herald. She’s been a news reporter for more than 30 years in the Pacific Northwest.
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