Orlando Health is suing Liberty HealthShare in federal court

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Liberty HealthShare is being sued again in federal court, this time by a Florida-based healthcare system.

The Jackson Township Department of Sharing Health Care is accused of ordering its members to hide their membership so they could “illegitimately” get reduced rates for their medical care.

Orlando Health, a 3,200-bed nonprofit healthcare system in central Florida, filed the lawsuit in federal court in Florida on June 9. He is seeking a judge’s order for a full accounting of all medical services the health system has provided to members Liberty, a Christian nonprofit organization where members nationwide pay eligible medical claims each other.

The case was assigned to U.S. District Judge Paul G. Byron.

Learn more about the Liberty HealthShare lawsuits:Liberty HealthShare sued in federal court, members seek class action status

What does the Orlando Health lawsuit allege?

Orlando Health attorneys say in the five-page complaint they need a judge to intervene because only Liberty knows how many members of its health care sharing department have obtained medical services at a health facility. of Orlando and how much Liberty still owes for those services.

They say Orlando Health only learned he had served Liberty members when Liberty sent a letter Aug. 11 saying his records showed he owed Orlando Health about $1.1 million related to a “big block of claims”.

But Liberty’s letter, which is not included in the lawsuit, does not identify which claims or even which members were patients, the lawsuit reads. The letter also referred to the existence of discrepancies in the claims, but did not identify the disputed claims.

On October 14, Orlando Health sent a letter to Liberty requesting a list of accounts so it could verify outstanding balances. But he said Liberty never responded.

Orlando Health officials say they then learned why they had no records showing they were serving Liberty members: Liberty had asked its members not to disclose their membership or that they were using Liberty. as a source of funding for medical expenses.

By doing so, the members were able to “unlawfully obtain the reduced ‘charity rate’ 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 does not comment on ongoing 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 never has been, an insurance company,” Ipson said. “Our members are viewed as self-paying patients and encouraged to self-identify as members of a health sharing ministry.”

Unlike traditional health insurance, members of Healthshares, such as Liberty, do not sign contracts and Healthshares do not claim liability for paying member claims. They see themselves as facilitators, matching the dues paid by one member to the medical needs of another member.

Nor do Liberty, which has about 70,000 members nationwide, and most other major shared health care departments pre-negotiate lower or in-network rates with medical providers.

Instead, Healthshares expect their members to individually get all the discounts available for the medical service. Some Healthshares will try to negotiate a lower price with a health care provider on the member’s behalf, but this happens after the service has been provided.

In addition to the Orlando Health lawsuit, Liberty is being sued in federal court by four members who claim Health Sharing misrepresented itself, sold illegal health insurance and funneled money meant to help to pay people’s medical bills to its leaders, friends and family.

The trial, which began in October, has stalled since February, when it was reassigned to new judge David A. Ruiz. Both sides are awaiting Ruiz’s decision on whether the lawsuit should be dismissed because Liberty and some of its vendors have already settled similar complaints with the Ohio Attorney General’s office.

Contact Kelli at 330-580-8339 or [email protected]

On Twitter: @kweirREP

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