A healthcare provider in Las Vegas is facing a lawsuit alleging it withheld a patient’s Medicaid billing, seemingly to prioritize a larger payout from a car crash settlement.
The complaint was filed by attorney Al Lasso in Clark County District Court on June 23, representing Mohammad Nyazi, who claims fraud and breach of contract against Dignity Health and Emerus Holdings.
According to the lawsuit, the defendants did not submit a billing request to Medicaid for Nyazi’s treatment, and the refusal was allegedly rooted in the belief that they could profit more from Nyazi’s legal claims stemming from a car accident.
The complaint states, “Upon information and belief, Defendants refused to bill Plaintiff’s Medicaid insurance based solely on the knowledge that Plaintiff was represented by legal counsel for potential claims arising from the underlying automobile crash.”
So far, the defendants have not responded to the court filings or requests for comments.
However, an attorney representing Dignity notified Lasso on July 23 that the hospital would now submit a bill to Medicaid, following media inquiries about the case.
Lasso noted a pattern where hospitals treating vehicle crash injuries may assume they will receive greater financial compensation from the individual rather than from insurance claims.
“If he just went in on anything but a motor vehicle crash, they would’ve definitely billed his insurance company, in my opinion,” Lasso explained.
Nyazi, a 36-year-old resident of Clark County, was injured in a car crash in March and sought treatment at the Dignity Health-Emerus Flamingo facility.
The hospital is a joint venture between Emerus and Dignity Health, as reported in an Emerus news release.
In May, Nyazi received a bill totaling $17,113, and a month later, Lasso’s injury firm received correspondence indicating that Dignity Health-Emerus had never billed Nyazi’s Medicaid insurance.
This revelation led to the lawsuit, which accused the healthcare provider of neglecting its obligations by not billing Medicaid, thus violating Nyazi’s rights to have those claims processed through insurance.
Dignity Health and Emerus have stated that they are adhering to federal and state laws by pursuing payment through third-party liability, as detailed in the complaint.
A spokesperson for Nevada Medicaid declined to comment on the legality surrounding the refusal to bill for treatment.
Lasso expressed his discontent with the situation, emphasizing that any individual seeking treatment should expect their insurance to be billed appropriately.
“It just doesn’t seem right,” Lasso remarked. “Anybody could walk in there and want to be treated for injuries and be told, ‘Oh yes, we’re going to bill your insurance company,’ they accept your insurance and then, the next thing you know, you get a bill for some $17,000.”
Nyazi is currently in line to receive a gross accident settlement of $25,000 from the driver responsible for the crash.
This lawsuit follows a similar case from last year, where Ronald McKean alleged that St. Rose Dominican Hospital failed to submit his bills to Medicare after he sought treatment following a car accident.
McKean noted in his complaint that he received a collections letter with a balance exceeding $67,000, highlighting ongoing issues within the healthcare billing system.
While attorneys for Dignity denied the allegations in McKean’s case, court records indicate that the hospital ultimately settled the matter.
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