Key Health Medical Solutions, Inc. and VBS Physical Therapists, Inc. have conspired to overcharge personal injury victims for the costs of medical services, a proposed class action claims.
More specifically, the suit alleges the defendants, a healthcare provider and medical funding provider, jointly inflate the costs of physical therapy services given to personal injury victims. These individuals, the lawsuit alleges, are then forced to pay “these unreasonable and unconscionable fees” out of the proceeds of their personal injury settlement or verdict or forced to have the money held in trust until their bill from Key Health and VBS is resolved.
After completing physical therapy treatment for injuries sustained in a car accident, the plaintiff, a South Carolina resident, was sent a bill that the lawsuit alleges “greatly exceed[ed] the reasonable and customary charges” for the services she received, the costs of which the suit claims were sought through a lien on the woman’s personal injury claim.
According to the case, the plaintiff was involved in an October 2015 automobile collision due to the negligence of another driver and filed a claim for damage sustained as a result of the accident. As part of her necessary medical treatment, the plaintiff was referred to VBS for physical therapy, the suit explains.
Because the plaintiff was unable to work due to her injuries and could not afford to pay the costs of the therapy in advance, VBS agreed to provide physical therapy services on the condition that the plaintiff signed an agreement with Key Health granting the medical funding company the right to collect all amounts due for services out of the woman’s personal injury settlement or verdict funds, the lawsuit says. After signing the agreement, the plaintiff allegedly received 24 physical therapy treatments, ranging in price from $382 to $389 per visit, for a total cost of $9,282.00.
The lawsuit argues, however, that the “reasonable value” for the physical therapy treatments received by the plaintiff were less than $100.00 per visit—three to four times less than the costs charged by the defendants.
Per the case, “[t]here was no valid basis or justification” for the defendants’ inflation of the plaintiff’s bill, which the plaintiff alleges significantly exceeded the “reasonable and normal costs” for physical therapy services.
“The inflated amount billed by Key Health was a sham that did not reflect, as the assignment falsely stated, ‘the amount due for services by the Physician/Facility’, the ‘ordinary and customary charge’ for the medical services, or administrative charges,” the complaint avers.
According to the suit, Key Health and VBS have engaged in a pattern and practice of charging “unfair, unreasonable and inflated prices” for medical care to accident victims who, in many cases, may not be able to afford them. The lawsuit claims the defendants’ conspiracy included a business arrangement between VBS and Key Health to actively recruit patients to enter into assignment with Key Health; a joint determination as to the fees to be charged per visit and the division of the charges between the two companies; and an agreement that Key Health will pay VBS its share of the fees upon completion of services in amounts “far higher than VBS would receive for the services rendered.”
The case, which was removed to South Carolina District Court on October 26, goes on to claim that Key Health has likely entered into similar agreements with other medical providers who are yet to be identified.
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