Las Vegas Sun

March 28, 2024

Lawsuit alleges UMC misclassified patients, overcharged millions

UMC

Sam Morris

The entrance to University Medical Center’s trauma unit and emergency room is shown in 2009.

A lawsuit seeking class action status has been filed against University Medical Center, claiming the Las Vegas hospital has overcharged thousands of patients millions of dollars over the years by misclassifying them as trauma patients.

The suit, filed Thursday in Clark County District Court, says that on March 31, Karla Reyes-Sandino of Las Vegas was treated for 90 minutes at UMC for neck pain after a car accident.

A nurse evaluated the patient and found she did not meet "trauma field criteria," the lawsuit says.

A CT scan of her brain and spine found them to be normal and she was discharged in good condition, the lawsuit says.

In April, Reyes-Sandino was billed $11,830, including $8,109 in "trauma" charges despite her not being assessed as a trauma patient, the lawsuit says.

"For years, UMC unlawfully billed and collected from emergency room patients millions of dollars in 'trauma' charges when the patients were not trauma patients, and/or were misclassified by UMC as trauma patients and/or did not utilize UMC’s trauma facilities in order to allow UMC to unlawfully ... bill each patient thousands of dollars in additional medical charges," the lawsuit charges.

Henderson attorney Jesse Sbaih, who filed the lawsuit, said he’s aware of at least two other patients who had similar experiences with UMC.

In the case of Reyes-Sandino, Sbaih said UMC eventually agreed to lower the bill to $7,800 – an amount Sbaih maintains is still inflated by UMC misclassifying his client as a trauma patient.

Sbaih said that even when an insurance company pays the UMC bill, patients like Reyes-Sandino are still harmed by UMC’s practice.

He said that’s because, under a typical auto insurance policy, money paid by the insurer to UMC reduces the money available for payment to the patient for her pain and suffering.

The suit asserts claims of violations of the Nevada Deceptive Trade Practices Act, fraud and unjust enrichment.

UMC has not yet responded to the lawsuit. A message for comment was left with the hospital Monday.

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