Wood v. North Mississippi Medical Center, Inc.

District Court, N.D. Mississippi·Decided September 29, 2023·No. 1:20-cv-00042·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF MISSISSIPPI ABERDEEN DIVISION

STANLEY WOOD and CHASTITY PLAINTIFFS WOOD, Individually, and on Behalf of a Class of Similarly Situated Persons

v. CIVIL ACTION NO. 1:20-cv-42-TBM-RP

NORTH MISSISSIPPI HEALTH SERVICES, INC. et al. DEFENDANTS MEMORANDUM OPINION AND ORDER On February 23, 2021, Stanley and Chastity Wood, a husband and wife, filed their First Amended Class Action Complaint [45] on behalf of themselves and similarly situated persons. Their claims stem from alleged balance bills that the Defendants sent Chastity Wood,1 and the methods by which the Defendants sought to collect the debt. In their Amended Complaint, the Woods assert five causes of action against North Mississippi Health Services, North Mississippi Clinics, LLC, North Mississippi Medical Center, Inc., Tupelo Service Finance (collectively, the “Hospital Defendants”), and Alliance Collection Service, Inc. (“Alliance”) including: (1) violations of the Fair Debt Collection Practices Act; (2) violations of Mississippi Code Section 83- 9-5; (3) fraud and misrepresentation; (4) breach of contract; and (5) civil conspiracy. Now before the Court is the Woods’ Motion to Certify Class [195]; Alliance’s Motion to Dismiss or for Summary Judgment [221]; and the Hospital Defendants’ Motion for Partial Summary Judgment [223]. For the reasons discussed fully below, Alliance’s Motion to Dismiss or

1 Balance billing occurs when medical providers bill a patient for the difference between the amount they charge, and the amount the patient’s insurance approves and actually pays. There are different examples when dealing with out of network providers. But one example is when a medical provider charges $100 for services, but the patient’s insurance company only pays $70; balance billing can occur if the medical provider then sends a bill to the patient for the remaining $30. for Summary Judgment [221] is granted, and the Hospital Defendants’ Motion for Partial Summary Judgment [223] is granted. Accordingly, the Court dismisses the Woods’ Fair Debt Collection Practices Act claims; dismisses the Woods’ alleged statutory violations claims based on

Mississippi Code Section 83-9-5; dismisses the Woods’ fraud and misrepresentation claims against Alliance; dismisses the Woods’ fraud and misrepresentation claims against the Hospital Defendants in part;2 dismisses the Woods’ breach of contract claims against Alliance; dismisses the civil conspiracy claims against Alliance; and dismisses the civil conspiracy claims against the Hospital Defendants in part.3 In short, all of the Woods’ claims against Alliance are dismissed, and the Woods’ claims for fraud and misrepresentation, breach of contract, and civil conspiracy,

against the Hospital Defendants will continue as set forth in this Opinion. For these reasons, only the Woods’ breach of contract claims against the Hospital Defendants remain for class certification consideration.4 Upon review of the Woods’ Motion to Certify Class [195], the Woods’ proposed class is not clearly defined. But even if it was, the Woods’ Motion would fail on numerosity grounds. For the reasons discussed fully below, the Woods’ Motion to Certify Class [195] is denied without prejudice to allow for refiling after sufficient discovery has been completed.

2 The fraud and misrepresentation claims against the Hospital Defendants based on Mississippi Code Section 83-9-5 are dismissed, but those based on the alleged tax-time deal remain.

3 The civil conspiracy claims based on Mississippi Code Section 83-9-5 and the FDCPA are dismissed, but the civil conspiracy claim premised on the Woods’ breach of contract claim remains.

4 The Woods do not move for class certification of their fraud and misrepresentation claims or their civil conspiracy claims. I. BACKGROUND AND PROCEDURAL HISTORY In 2017, Chastity Wood “required dozens of non-elective medical treatments, including blood and iron transfusions.” [45], pg. 2. She received treatments from various providers in the

North Mississippi Health Services system, such as North Mississippi Clinics, LLC, and North Mississippi Medical Center, Inc. (collectively “the medical providers”). Id. at pg. 3. Through her employer, Chastity was insured under an employee benefit plan administered by Health Cost Solutions, and her husband, Stan, was insured under the state health plan administered by Blue Cross/Blue Shield. Id. According to the Amended Complaint [45], the Woods “examined their plan documents before the treatments began and determined the lower annual deductible under

Chastity’s plan would save them from significant expense.” Prior to providing treatment to Chastity, the medical providers required that she present a card demonstrating entitlement to coverage pursuant to an insurance policy or health plan. Id. The Woods assert the medical providers confirmed that Chastity was entitled to coverage under her employee benefit plan (“the Plan”) and required Chastity to execute a “Consent for Treatment, Admission, and Release of Health Information.” Id. at pg. 5. The consent form included an assignment of benefits that gave the medical providers a guarantee of payment via an assignment

of “all rights, benefits and interest under [her] health plan . . . in consideration for services rendered.” Id. (internal quotations and citations omitted). According to the Woods, Health Cost Solutions paid at least 48 claims for medical services that Chastity received and “[a]t least nine of the 48 claims were pre-certified and paid at an agreed upon rate.” Id. Setting aside those nine claims, the others “were paid consistent with the express terms, conditions and limitations of the Plan Documents at 140% of the rate Medicare would have paid.” Id. at pg. 6. In 2018, at some point after receiving at least 48 payments from Health Cost Solutions, the

medical providers demanded that the Woods pay almost $50,000.00 in additional payments. Id. Collection efforts were presumably commenced by Tupelo Service Finance and Alliance, on behalf of the medical providers. The Woods assert that they communicated with Health Cost Solutions, Tupelo Service Finance, and Alliance in an attempt to resolve the situation, but were unable to reach a resolution. Id. at pg. 7. The Woods contend that in March 2019 the Hospital Defendants offered a special “tax

time deal,” and if the Woods agreed to pay their debt before April 1, 2019, they could receive a limited-time 20% discount. Id. at pg. 7. As alleged by the Woods, “[f]earing they would miss out on a one-time opportunity to obtain a discounted rate, [they] rushed to Renasant Bank on March 21, 2019, and completed a consumer loan application.” Id. The Woods secured a home equity line of credit and, on March 26, 2019, paid the following amounts: “$6,041.14 to [North Mississippi Medical Center, Inc.], $6,412.62 to [Tupelo Service Finance], and $29,489.00 to [Alliance].” Id. After paying these amounts and believing that the matter was resolved, the Woods received

another letter from Alliance in October 2019, where Alliance demanded an additional payment of $8,936.05. Id. at pg. 8. Upon receipt of this new demand, the Woods reached out to the Mississippi Insurance Department for help. Id. On November 14, 2019, the Mississippi Insurance Department wrote to Alliance explaining that balance bills for unauthorized and non-allowed amounts were prohibited by Mississippi law. Id. Despite this letter, the Woods assert that Alliance began calling Chastity “multiple times in a harassing attempt to obtain payment, including, on January 30, 2020 and February 4, 7, 10, 13, 17, and 20, 2020.” Id. “The calls did not cease until this action was commenced on February 26, 2020.” Id. at p. 8. The Woods filed this putative class action on behalf of themselves and similarly situated

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Wood v. North Mississippi Medical Center, Inc., (N.D. Miss. 2023).

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