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How Much Can Hospitals in CA Charge Patients Without Insurance?

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By William Vogeler, Esq. on September 25, 2018 3:50 PM

An unpublished case about a $7,812 medical bill could change the way hospitals charge patients without insurance in California.

It depends on two main questions: Will a decision stand that allows self-pay patients to challenge their bills? And will the California Supreme Court certify the decision for publication?

In Solorio v. Fresno Community Hospital and Medical Center, the answers could change everything. It's not just about the $7,812 bill; it's about how much hospitals can charge.

Bill Disputes

Like many of the 300 patients who check in to the emergency room at Community Regional Medical Center in Fresno each day, Cesar Solorio showed up with a minor injury. Two X-rays and a splint later, he left with a bill he couldn't afford.

He disputed the charges, then found a lawyer to sue. Barry Kramer filed for a class-action, but the trial judge turned him down.

The Fifth District Court of Appeals, however, gave him another shot. The judges observed that similar disputes had arisen across the country, and certified a class of self-pay patients who were billed for emergency services at the local hospitals.

Ultimately, the case will turn on how the hospitals bill. The plaintiff's attorney said they can charge up to five times the amount that insured patients are charged.

Double the Stakes

The community medical centers have appealed the decision to the state supreme court, and Kramer has petitioned the court to have the decision published. The cross-appeals have doubled the stakes.

"Without the publication, the ruling would still apply to Fresno, the hospital here, but it wouldn't be citable and usable for other cases in California," Kramer told the Fresno Bee.

Glenn Melnick, a health economics professor, said the case is valuable in any case.

"Anything that helps to shine a light on this policy that needs to be changed would help all of us," he said.

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