Loper v. Lifeguard Ambulance Service LLC

CourtDistrict Court, N.D. Alabama
DecidedSeptember 29, 2021
Docket2:19-cv-00583
StatusUnknown

This text of Loper v. Lifeguard Ambulance Service LLC (Loper v. Lifeguard Ambulance Service LLC) is published on Counsel Stack Legal Research, covering District Court, N.D. Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Loper v. Lifeguard Ambulance Service LLC, (N.D. Ala. 2021).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ALABAMA SOUTHERN DIVISION

HEATHER LOPER, on behalf of ) herself and all others similarly ) situated, ) ) Plaintiff, ) ) v. ) Case No. 2:19-CV-583-CLM ) LIFEGUARD AMBULANCE ) SERVICE, LLC, ) ) Defendant. ) MEMORANDUM OPINION AND ORDER Heather Loper brought a class action against Lifeguard Ambulance Service, LLC, to challenge Lifeguard’s alleged practice of billing certain ambulance passengers excessive rates without contracting for or otherwise disclosing the price Lifeguard would charge for its services. Lifeguard seeks summary judgment on Loper’s individual claims. (Doc. 51). And Lifeguard asks the Court to strike and disregard evidence of certain forms of monetary harm that Loper claims she suffered as a result of Lifeguard’s billing practices. (Doc. 74). In sum, the Court grants in part and denies in part Lifeguard’s motion for summary judgment, and the Court grants in part and denies in part Lifeguard’s motion to strike and disregard. FACTUAL AND PROCEDURAL BACKGROUND The Court draws the facts from the summary-judgment record. At this stage of the litigation, “[a]ll evidence and factual inferences are viewed in the light most favorable to the non-moving party, and all reasonable doubts about the facts are

resolved in favor of the non-moving party.” Hardigree v. Lofton, 992 F.3d 1216, 1223 (11th Cir. 2021). I. Factual Background of Loper’s Claims

A. Ordering the Transport In March 2017, Loper was a patient at Thomas Hospital in Fairhope, Alabama. (Docs. 55 ¶ 1, 61 ¶ 1). After a few days in the hospital, Loper’s doctor decided to transfer her either to UAB Hospital in Birmingham or Vanderbilt Hospital in

Nashville, whichever had the first available bed, to obtain more effective treatment. (Docs. 55 ¶ 2, 61 ¶ 2). Loper’s doctor contacted both hospitals on her behalf. (Id.). Several days later—on Saturday, March 11—Vanderbilt Hospital informed

Loper’s doctor that it had an available bed. (Docs. 55 ¶ 3, 61 ¶ 3). But Loper had only 24 hours to make it to Nashville, 458 miles away. (Docs. 55 ¶ 3, 61 ¶ 3, 67-2 at 256). Otherwise, Loper would lose the bed. (Docs. 55 ¶ 3, 61 ¶ 3). Loper’s husband, Murray, handled her communications because Loper “was

under extreme pain and under severe medication.” (Docs. 55 ¶ 4, 61 ¶ 4, 67-3 at 30). 2 When Loper’s doctor told Murray that Vanderbilt Hospital had an open bed (Docs. 55 ¶ 3–4, 61 ¶ 3–4), Murray authorized Thomas Hospital to arrange for a ground ambulance to take Loper to Vanderbilt Hospital (Doc. 67-3 at 26). The same day, Thomas Hospital contacted Lifeguard about providing an ambulance transport.

(Docs. 55 ¶ 6, 61 ¶ 6). And the hospital directed Lifeguard to deliver Loper by no later than Sunday, March 12, which was the next day. (Docs. 55 ¶ 12, 61 ¶ 12). B. Disclosing the Cost

Two of Lifeguard’s policies need explanation. First, Lifeguard’s billing structure. For uninsured passengers and privately insured passengers, like Loper, Lifeguard calculates its price based on a formula that reflects: (1) whether the transport is emergent or non-emergent; (2) the level of care that ambulance

technicians provide during the trip (there are four levels); and (3) the transport distance multiplied by a per-mile rate. (Docs. 55 ¶ 9, 61 ¶ 9). Second, Lifeguard’s “Out-of-Town Transport Policy.” Lifeguard usually

investigates a passenger’s insurance coverage before conducting any non- emergency transport that exceeds 100 miles. (Docs. 55 ¶ 7, 61 ¶ 7). And if the passenger lacks coverage for any portion of the estimated bill, Lifeguard prepares a written quote showing the amount it plans to charge, the passenger’s insurance

coverage, and how much that the passenger will have to pay personally. (Id.). The 3 policy itself says to “[p]rovide [a] quote for expected charges the [passenger] will incur.” (Doc. 62-2 at 250). After doing so, Lifeguard obtains a written, pre-transport commitment from the passenger that he or she will pay the amount not covered by insurance. (Docs. 55 ¶ 7, 61 ¶ 7).

Lifeguard knew that Loper had health insurance through BlueCross and BlueShield of Alabama. (Docs. 55 ¶ 11, 61 ¶ 11). But because this story began on Saturday and concluded on Sunday, Lifeguard was unable to determine the amount

of coverage BlueCross would provide and thus didn’t know whether BlueCross would pay for all, some, or none of the transport. (Id.). So Lifeguard didn’t make a pre-transport disclosure of the estimated cost. (Docs. 55 ¶ 14, 61 ¶ 14). Lifeguard says that it didn’t for three reasons. First, it had

no way to know the scope of Loper’s coverage. (Doc. 55 ¶ 12). Second, it had no chance to discuss the cost with Loper or Murray because the hospital coordinated the pick-up. (Doc. 55 ¶ 14). And third, neither Loper nor Murray asked about the

cost. (Id.). Still, even though Lifeguard says it had no way or chance to make a complete pre-transport disclosure of the amount Loper would have to pay herself, its corporate representative testified in his deposition that Lifeguard could have made a limited disclosure based on available information. (Doc. 67-2 at 91).

4 Loper and Murray believed that BlueCross would cover the entire cost. In his deposition, Murray vaguely recalled a Thomas Hospital representative saying that BlueCross would cover the transport. (Doc. 67-3 at 28, 31). And Loper and Murray each recalled an on-site Lifeguard representative saying that insurance would cover

the trip. (Docs. 67-3 at 43, 67-4 at 10). C. Billing the transport Lifeguard picked up Loper on Sunday morning and delivered her to

Vanderbilt Hospital around 5:00 PM that afternoon. (Docs. 55 ¶ 13, 61 ¶ 13, 67-2 at 256). Near the end of the transport, at 4:45 PM, Loper signed an agreement (“Acknowledgment Form”) stating: The person signing below . . . assigns to Supplier all rights to (and related or associated with) any benefits claims and/or payments due from any third-party payor as reimbursement or payment for the Services . . . [and] agrees that the patient is financially responsible for, and obligated to pay, the amount charged by Supplier for the medical services, including any amount that is not paid by any third-party payor.

(Docs. 55 ¶ 15, 61 ¶ 15, 67-2 at 242). But the form did not set out the amount that Lifeguard would charge. (Docs. 67-2 at 67, 242–43). Lifeguard submitted an $8,166.11 bill to BlueCross. (Docs. 55 ¶ 16, 61 ¶ 16). That amount represented Lifeguard’s base charge of $590.79 for a non-emergency basic-life-support transport and a mileage charge of $7,575.32 (458 miles at $16.54 5 per mile). (Doc. 55 ¶ 10, 16; Doc. 61 ¶ 10, 16). Lifeguard calculated the total using its commercial rates for uninsured and privately insured passengers. (Docs. 55 ¶ 17, 61 ¶ 17, 67-2 at 116–17). But the parties dispute whether those align with “market” rates. (Docs. 55 ¶ 18, 61 ¶ 18).

BlueCross paid $3,889.96 to Lifeguard. (Docs 55 ¶ 19, 61 ¶ 19, 67-3 at 88– 89). That amount represented Loper’s $4,862.45 in coverage minus Loper’s 20% deductible. (Id.). BlueCross then sent a notice to Murray that explained the amount

it paid and that Loper still owed $4,276.15 to Lifeguard—i.e., the sum of her deductible and the balance of the charge. (Id.). In April 2017, Lifeguard sent an invoice to Loper for $4,276.15. (Doc. 67-3 at 91). Then, in August 2017, Lifeguard referred the debt to a collection agency. (Doc. 61 ¶ 22; Doc. 67-4 at 16, 49).

So Loper hired an attorney. In December 2017, Loper’s counsel sent a letter to Lifeguard expressing that no written contract existed, that Loper did not consent to charges beyond what BlueCross paid, and that Lifeguard’s rates were

unreasonable. (Doc. 67-4 at 73–74). Loper made several demands, including “[c]ease and desist any attempts at collection,” and she threatened to sue. (Id.).

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