Liberty HealthShare is back in federal court, this time from a Florida-based health system.
The Jackson City Department of Health has been accused of instructing its members to hide their membership so they could “illegitimately” receive reduced rates for their medical care.
Orlando Health, a nonprofit health system with 3,200 beds in central Florida, filed a lawsuit in federal court in Florida on June 9. It wants a judge’s order to take full account of all medical services provided by the health care system to members of Liberty, a non-profit Christian organization in which members across the country pay each other eligible medical claims.
The case was assigned to U.S. District Judge Paul G. Byron.
More on Liberty HealthShare lawsuits:Liberty HealthShare has filed a lawsuit in federal court, with members seeking collective redress status
What does the Orlando Health case say?
Orlando Health attorneys say in the five-page complaint that they need a judge to intervene because only Liberty knows how many members of her Department of Health care have received medical services at an Orlando health facility and how much is still owed. Liberty for these services.
They say Orlando Health learned it was serving Liberty members only when Liberty sent a letter on Aug. 11 saying records show it owed Orlando Health approximately $ 1.1 million related to “a large block of claims’.
But Liberty’s letter, which was not included in the case, did not identify which claims or even which members were patients, the lawsuit said. The letter also states the existence of discrepancies in the claims, but does not specify which claims are disputed.
On October 14, Orlando Health sent a letter to Liberty requesting a list of accounts so that it could verify the outstanding balances. But it says Liberty never responded.
Orlando Health officials say they then learned why they did not have records showing that they serve Liberty members: Liberty instructed its members not to disclose their membership or that they used Liberty as a source of funding for medical expenses.
In this way, members were able to “illegitimately provide a reduced rate of charity” for medical services, according to the lawsuit.
Kena Lewis, a spokeswoman for Orlando Health, declined to answer further questions about the lawsuit, saying the health system did not comment on pending lawsuits.
What does Liberty HealthShare say?
Terry Epson, vice president of marketing and communications for Liberty HealthShare, said Liberty does not discuss active litigation in detail.
“What we can say is that Liberty HealthShare is not and never was an insurance company,” Ipson said. “Our members are considered self-paying patients and are encouraged to identify as such as members of the Ministry of Health Sharing.”
Unlike traditional health insurance, Healthshares members, such as Liberty, do not sign a contract and Healthshares does not take responsibility for paying members’ claims. They are considered facilitators by comparing the contributions paid by one member with the medical needs of another member.
Liberty, which has about 70,000 members nationwide, and most of the other major health-sharing ministries also do not pre-negotiate lower or domestic tariffs with healthcare providers.
Instead, health shares expect their members to receive individually any discounts available for the medical service. Some health stocks will try to negotiate a lower price with a healthcare provider on behalf of the member, but this happens after the service is provided.
In addition to the health lawsuit in Orlando, Liberty has been tried in federal court by four members who allege that health participation was misrepresented, sold illegal health insurance and directed money that was supposed to help pay medical bills to his leaders and their friends and family.
The case, which began in October, has remained stalled since February, when it was reassigned to newly appointed Judge David A. Ruiz. Both sides are awaiting Ruiz’s decision on whether the case should be dismissed, as Liberty and some of its suppliers have already settled similar complaints with the Ohio Attorney’s Office.
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