Kaiser Won’t Pay Bill, St. Jude Says

8-1-2013 23:56:00

SANTA ANA, Calif. (CN) - A Kaiser hospital in Orange County broke a mutual service agreement with St. Jude Medical Center by not paying over $100,000 in medical care provided to Kaiser patients, the hospital claims in a complaint filed in Alameda County Superior Court.

According to the complaint, two patients were treated at St. Jude in July 2011, but insurance coverage determination was delayed for both, causing them to stay at the hospital instead of being transferred to a Kaiser facility. The combined cost for care of the two patients totaled over $200,000, but Kaiser alleges it only owes St. Jude for medical costs incurred on the day of each patient’s admission. Under an Agreement for Hospital Services signed by both parties, each hospital is entitled to a discounted rate if bills are paid in full within 60 days.

Kaiser only made partial payments totaling over $107,000, prompting St. Jude to bill the hospital its normal customary charges, according to the complaint.

St. Jude claims Kaiser still owes a total of $103,662.36.

“Kaiser unfairly interfered with the hospital’s (St. Jude) right to receive the benefits of the agreement by failing to pay the hospital the amounts required by the agreement after the hospital provided medically necessary services to the patients and billed Kaiser for those treatments,” the complaint states.

St. Jude is suing for unfair business practices, breach of contract, breach of covenant of good faith and fair dealing, open book account and unjust enrichment.

Plaintiff is represented by Jonathan F. Buck and Steven D. Sperling, of the Helton Law Group in Huntington Beach, Calif.