LAFAYETTE — Acadian Ambulance Service Inc., headquartered in Lafayette, is one of several Louisiana companies being sued for tens of millions of dollars by people who claim they were fraudulently billed for services.
The companies are accused of violating a 2004 state law enacted to tame what the industry calls “balance billing.”
A state district judge in Marksville last month ruled that Acadian, which started in Lafayette in 1971, should pay 1,924 members of a class action lawsuit an amount of money that, with interest that accumulates every day, now tops $20 million.
“At the outset, this court recognizes that increasing one’s profit margin is not evil,” 12th Judicial District Judge Mark Jeansonne wrote in his Dec. 12 judgment against Acadian Ambulance. The ruling followed a two-day bench trial.
“However, when an entity attempts to skirt Louisiana Law in order to increase profits, and further invade a person’s assets held by an attorney, then seeking to increase profits becomes sinister,” Jeansonne wrote.
Acadian has a Feb. 4 hearing before Jeansonne to ask for a new trial, and is getting ready to file papers for a review by the state 3rd Circuit Court of Appeal, attorneys in the case said.
Allyson Pharr, senior vice president of legal and government affairs for Acadian, said in an email that Jeansonne’s ruling was expected.
“Based on factors unrelated to the merits of the case, while we are disappointed, we are not surprised by this ruling and look forward to having the merits of the case fully and properly examined by the appeals court,” Pharr said.
“This case is about an interpretation of a contract regarding billing procedures, and Acadian firmly defends our billing process,” Pharr said.
Acadian started balance billing in the 1990s, Judge Jeansonne said, with “patients who had health insurance and were involved in liability accidents.”
The billing practice was common among health providers until the Legislature passed the Health Care Consumer Billing and Disclosure Protection Act, which went into effect Jan. 1, 2004.
“The law prohibits a contracted health care provider from collecting or attempting to collect from a patient any amounts in excess of the contracted reimbursement rate,” Jeansonne wrote.
Rather than bill the patient’s insurance company for the pre-negotiated amount, Acadian would seek more money by getting a collection agency to place a lien on the settlement, the judge wrote.
The settlement money would pay the enhanced bill, one that eclipsed the rate that had been negotiated between Acadian and the patient’s insurance carrier, Jeansonne wrote.
In the end, it didn’t matter that the patient had insurance that should have paid for the ride to the hospital, Jeansonne said.
“They (Acadian) had a whole department whose sole purpose was to see if someone is liable for their bill,” said Derrick “Digger” Earles, an attorney in Marksville who filed the lawsuit against Acadian.
In a 2011 lawsuit involving West Calcasieu Cameron Hospital in Sulphur, state district Judge Kent Savoie said the Legislature passed the consumer law to remedy a 1990 statute that allowed a company to lien settlements.
“The Legislature … generally speaking … doesn’t do anything unless somebody is abusing something,” Savoie said, according to a transcript of the proceedings.
Plaintiffs in the West Calcasieu Cameron Hospital prevailed, said Lee Hoffoss, a Lake Charles attorney who is representing the plaintiffs in the Acadian lawsuit.
Hoffoss said his firm has filed lawsuits against 13 other health-care companies that engaged in the same billing practice.
He said a state attorney general opinion on the 2004 law that some have interpreted as nullifying the 2004 statute hasn’t passed the scrutiny of the two judges, Jeansonne and Savoie.
Other Lafayette companies being sued by a class of plaintiffs represented by Hoffoss and Earles include The Schumacher Group and Lafayette General Health System.
“It’s early on in the litigation, and the volume of claims we’ve identified with the plaintiffs is a very small number,” said Ryan Domengeaux, vice president of risk management and in-house attorney for The Schumacher Group.
Other Louisiana companies named in lawsuits include Ochsner Health System, Christus St. Patrick Hospital and Ville Platte Medical System.
Earles, the Marksville attorney, said the majority of health-care companies in Louisiana have followed the 2004 law.
“There are a lot of them that did the right thing, who knew the law and refused to practice balance billing,” Earles said.