On March 31, 2016, the Twenty-First Judicial Circuit of Virginia for Henry County, Patrick County, and City of Martinsville issued a scholarly 11-page opinion in Dennis v. PHC-Martinsville, Inc. t/a Mem’l Hosp. of Martinsville & Henry County, No. CL14-483. It disposed for only $523.89 the overly-aggressive “balance billing” of $83,860.42 by the hospital in an amended counter-claim to the victim patient’s medical malpractice suit. Id. at 10.
Dennis held that the counter-plaintiff hospital failed to prove that its “contract of adhesion” was a binding contract. Id. at 9. It observed that the hospital having the patient sign while “his life was on the line” was a “coercive proposition;” and that the hospital denying the compromised patient access to the “secret” pricing of its “CDM (‘charge master description’)” was a “significant objective manifestation, by conduct of a party, that no contract was created”. Id. at 8.
Analyzing the hospital’s claim under its alternative quantum meruit theory, Dennis analogized the defendant patient to an uninsured patient who had pre-arranged payment (who thereby would have received a 75% discount from the hospital). Id. at 10. Discounting the $111,115.37 two-night bill by 75%, the court found the services’ reasonable value to be only $27,778.40; of which $27,254.95 already had been paid by the patient’s insurer (which unfortunately did not have a contractual relationship with the hospital). Id.
