Orlando Health sues Liberty HealthShare after members ‘illegitimately’ got lower rates
Liberty HealthShare once again is being sued in federal court, this time by a Florida-based health system.
The Jackson Township health care sharing ministry is accused of instructing its members to hide their memberships so they could “illegitimately” obtain reduced rates for their medical care.
Orlando Health, a nonprofit, 3,200-bed health system in central Florida, filed the lawsuit in a Florida’s federal court on June 9. It is seeking a judge’s order for a full accounting of all the medical services that the health system provided to members of Liberty, a Christian nonprofit organization where members nationwide pay each other’s eligible medical claims.
The case has been assigned to U.S. District Judge Paul G. Byron.
More on Liberty HealthShare’s lawsuits: Liberty HealthShare sued in federal court, members seek class-action status
What does Orlando Health’s lawsuit allege?
Attorneys with Orlando Health say in the five-page complaint they need a judge to intervene because only Liberty knows how many members of its health care sharing ministry obtained medical services at an Orlando Health facility and how much Liberty still owes for those services.
They say Orlando Health only learned that it had been serving Liberty members when Liberty sent a letter on Aug. 11 that said its records indicate that it owes Orlando Health roughly $1.1 million related to a “large block of claims.”
But Liberty’s letter, which is not included with the lawsuit, didn’t identify which claims or even which members had been patients, the lawsuit reads. The letter also referred to the existence of discrepancies in the claims, but didn’t identify which claims were in dispute.
On Oct. 14, Orlando Health sent a letter to Liberty requesting a list of the accounts so it could verify the outstanding balances. But it said Liberty never responded.
Orlando Health officials claim they then learned why they had no records indicating they were serving Liberty members: Liberty had instructed its members to not disclose their membership or that they used Liberty as their source of medical cost funding.
By doing so, the members were able to “illegitimately secure the reduced ‘charity rate’ for medical services,” according to the lawsuit.
Kena Lewis, a spokesperson for Orlando Health, declined to answer further questions about the lawsuit, stating the health system does not comment on pending litigation.
What does Liberty HealthShare say?
Terrie Ipson, 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 has never been, an insurance company,” Ipson said. “Our members are considered self-pay patients and encouraged to identify themselves as such as a member of a healthsharing ministry.”
Unlike traditional health insurance, members of healthshares, such as Liberty, do not sign a contract and the healthshares claim no responsibility for paying member claims. They consider themselves facilitators, matching up one member’s paid contributions to another member’s medical needs.
Liberty, which has roughly 70,000 members nationwide, and most of the other large health care sharing ministries also don’t negotiate lower or in-network rates with medical providers ahead of time.
Instead, the healthshares expect their members to individually obtain any discounts available for the medical service. Some healthshares will try to negotiate a lower price with a health provider on the member’s behalf, but that happens after the service has been provided.
Besides the Orlando Health lawsuit, Liberty is being sued in federal court by four members who claim the healthshare misrepresented itself, sold illegal health insurance and funneled money that was supposed to help pay people’s medical bills to its leaders and their friends and family.
The lawsuit, which began in October, has remained at a standstill since February when it was reassigned to newly appointed Judge David A. Ruiz. Both sides are waiting for Ruiz’s decision on whether the lawsuit should be dismissed because Liberty and some of its vendors already settled similar complaints with the Ohio Attorney General’s Office.
Reach Kelli at 330-580-8339 or [email protected]
On Twitter: @kweirREP
This article originally appeared on The Repository: Orlando Health sues Liberty HealthShare in federal court