SSM Health Charges Emergency Care Patients Undisclosed Visitation Fees, Class Action Says

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A proposed class action alleges SSM Health and its affiliated facilities in Missouri have unlawfully failed to inform emergency room patients that they will be charged a significant visitation fee.

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The 22-page lawsuit was filed by a Missouri resident who, after visiting the emergency room at SSM Health St. Louis University Hospital in June 2018 and SSM Health St. Mary’s Hospital – St. Louis in July 2018 and January 2020, was shocked to learn that she had been charged a separate visitation fee on top of the billable charges for the treatment and services she received.

The plaintiff claims that these charges—$2,513.20, $496 and $964—were never described, mentioned or disclosed to her before they were incurred. According to the case, the defendants had a legal duty to disclose their intention to bill substantial visitation fees as part of the total charges for an emergency room visit.

The complaint further notes that SSM Health’s website, which features a “price transparency” page that links to all the “shoppable services” available at each SSM Health location, makes no mention of emergency room visitation fees.

What’s more, the price transparency page provides links where patients can typically view “machine-readable files” that list the standard charges for each item of service or treatment provided during hospital visits, the lawsuit says. However, the filing notes that patients who click the St. Louis University Hospital or St. Mary’s Hospital links receive pop-up error messages stating that the PDF documents cannot be viewed.

“As such, SSM Health is in violation of state and federal regulations that require it to be transparent about prices and to avoid surprise billing its patients because no patient is able to access its ‘machine readable’ [charge description master],” the case states.

In addition, SSM Health and its affiliated hospitals leave patients in the dark about how visitation fees are calculated, the suit says. Per the filing, the visitation fee is determined after a patient is discharged, and based on an “unknown and hidden” process involving specific criteria categorized into five fixed levels.

“In making decisions regarding medical services, patients are owed, under the law, price transparency and informed consent,” the case reads, contesting that patients are not obligated to pay a visitation fee not described, mentioned or agreed to before receiving services at an emergency room.

The lawsuit looks to represent anyone in Missouri who, during the applicable statute of limitations period, received treatment at any of SSM Health’s emergency room facilities located in the state and was charged an emergency room fee which was billed in addition to the charges for the individual items of treatment and services provided.

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