The Ohio Osteopathic Association has filed an amicus brief along with four other parties challenging a Lucas County Appeal Court’s decision in Promedica V. King that a healthcare provider is prohibited from billing any entity or individual for reimbursement other than the health insuring corporation that covers the patient for primary medical services.
“This case is a serious threat to established billing procedures for all providers in Ohio,” said OOA Executive Director Jon F. Wills. “Even the Ohio Department of Insurance has weighed in on this interpretation.”
Other parties filing the amicus brief, January 3rd, included Mercy Health Partners and Catholic Health Partners, ProMedica Health Systems and the Toledo Hospital, the Ohio Hospital Association and the Ohio State Medical Association.
Mercy Health Partners is involved in ongoing litigation in a companion case, Dorothy Streeter v. Mercy Health Partners, which has virtually identical issues. The decision in that case has been stayed pending the decision by the Ohio Supreme Court. Plaintiff contends the respective healthcare providers violated Revised Code §1751.60 through their respective billing procedures when they sought compensation from a third-party payor, such as an automobile liability insurance carrier.
The OOA et al. brief alleges that the decision “leaves all of Ohio in a climate of confusion regarding the ability of medical providers to seek compensation for covered medical services provided to patients.” The brief further alleges, based on precedence by interpretations from the Ohio Department of Insurance, the statute only precludes a medical provider from seeking compensation, other than deductibles and co-payments, directly from an individual enrollee and/or subscriber of a health insuring corporation for covered medical services and that the statute does not preclude a medical provider from seeking compensation from available third-party payors.