Kaiser Provides Coverage, Then Reverses Payments, Woman Claims

1-30-2014 21:39:00

     SEATTLE, Wash. (CN) – A hospital unjustly sent a woman’s medical bill to a collection agency, which filed a lawsuit, publicly exposing her personal information, she claims in a complaint filed in King County Superior Court.
     Diana Noman received medical care from Group Health Cooperative (GHC) in 2010 and 2011. She claims in the complaint that she verified full coverage with Kaiser Permanente Health Alternatives prior to the appointments, to make sure she was covered for planned medical procedures.
     A GHC representative likewise confirmed, in Noman’s presence, that her Kaiser insurance covered all medical services. In addition, Noman says she again verified coverage at each appointment.
     “Based on communication with Group Health Cooperative and information received, plaintiff understood and understands that in fact her medicals were initially paid by her medical insurer, defendant Kaiser Permanente Health Alternative,” the complaint states.
Noman alleges that, at some point, the insurance payments made to GHC were reversed back to Kaiser without her knowledge.
     “Defendant Group Health Cooperative refunded the entire amounts already paid on her behalf back to Kaiser Permanente Health Alternative. Plaintiff was not aware of the developing situation until she received collection letters from Evergreen Professional Recoveries Inc., demanding payment of medical expenses,” according to the complaint.
     It is unclear why the payments were reversed or who initiated the action. A call to Noman’s attorney, Boris Petrenko, was not immediately returned.
     Consequently, Evergreen, which is not party to Noman’s action, filed an un-redacted and un-sealed collection lawsuit against her in King County District Court, making her information publicly available.
     “Diana Noman’s information was supplied to Evergreen Professional Recoveries Inc. by defendant Group Health Cooperative in violation of HIPAA (Health Insurance Portability and Accountability Act) protection,” according to the complaint.
Noman sued GHC and Kaiser, alleging unlawful disclosure of her medical and “other pertinent information” to a third party.
     All states are required to comply with HIPAA as of April 14, 2003. “Under HIPPA, no medical provider may disclose confidential health care information to third parties, unless such disclosure is either court ordered or made pursuant to consent by the patient,” the complaint states.
     Noman wants a court to declare her right to medical coverage, that GHC violated HIPAA when it disclosed her information to a third party and that she is not obligated to pay medical expenses.
     GHC is a nonprofit healthcare organization based in Seattle.
     The plaintiff is represented by Boris Petrenko, in Bellevue.