A recent lawsuit has been filed against a Las Vegas healthcare provider, accusing them of failing to bill Medicaid for a man’s treatment due to a belief that they could receive greater financial compensation from a car crash settlement.
Attorney Al Lasso filed the suit on behalf of Mohammad Nyazi in Clark County District Court, alleging that Dignity Health and Emerus Holdings committed fraud and breach of contract.
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.”
As of now, Dignity Health and Emerus Holdings have not responded to the lawsuit or requests for comments. However, on July 23, Lasso indicated that a lawyer for Dignity mentioned they would eventually submit the bill to Medicaid, a decision made after inquiries from a reporter.
Lasso, reflecting on his case against the healthcare provider, noted a troubling trend where hospitals may opt to seek higher payments from individuals involved in vehicle accidents, rather than billing their insurance directly. He suggested that if Nyazi had been treated for any other medical reason, the provider would likely have billed his insurance without hesitation.
Nyazi, 36, suffered injuries during a car crash in March and sought treatment at Dignity Health-Emerus Flamingo in Las Vegas. According to the suit, Nyazi received a medical bill totaling $17,113 in May. In June, Lasso’s firm received information from Dignity Health-Emerus communicating that they did not submit Nyazi’s Medicaid insurance for payment.
The lawsuit alleges that the healthcare provider intentionally omitted billing Medicaid and asserts that Nyazi had a right to have his claim submitted through that insurance.
In their defense, Dignity and Emerus have stated they were acting in compliance with state and federal laws, pursuing third-party liability for payment of medical services, which includes seeking compensation from liable parties after an accident.
A spokesperson for Nevada Medicaid has declined to comment on the legality of not billing Medicare or Medicaid for treatment.
“Anyone can walk in there and be treated for injuries, and when asked, they’ll be told that their insurance will be billed, but then they receive a hefty bill of over $17,000,” Lasso remarked, highlighting the injustice of the situation.
Nyazi is expected to receive a gross settlement of $25,000 from the driver who hit him.
This lawsuit is reminiscent of a similar case last year, in which Ronald McKean sued Dignity Health after treatment for a car accident resulted in a bill that was sent to collections. McKean’s complaint alleged that St. Rose Dominican Hospital failed to submit his medical bills to Medicare, leading to a balance due of more than $67,000.
Dignity’s attorneys denied the allegations in McKean’s suit, but court records suggest that Dignity ultimately reached a settlement in his case.
Though legal proceedings are still unfolding, the growing scrutiny on healthcare providers concerning billing practices, especially surrounding accidents, raises significant questions about the ethics of such actions.
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