Virginia Mason settles class-action suit alleging overbilling

In a case that has been watched carefully by hospital systems all over the country, Virginia Mason Medical Center has agreed to refund hospital "facility fee" charges to patients who received outpatient procedures at its downtown Seattle clinics.

The settlement in the class-action case, which affected more than 3,200 patients over the past six years, also requires Virginia Mason to begin providing estimates of outpatient services to patients in advance.

The details of the settlement, including how much Virginia Mason has agreed to pay, were not disclosed. A news conference was scheduled for this morning by the plaintiffs in the case.

One of the original plaintiffs was DeLois Gibson, a Skyway woman who went to Virginia Mason's downtown clinic in 2004 to have a blemish removed and was billed for $1,451, including $846 for hospital charges. Gibson claimed Virginia Mason acted unfairly and deceptively when it failed to tell her that she could have gotten the same procedure done at another Virginia Mason clinic without having to pay the hospital charge.

The case, the first of its kind in the country, was filed in January 2005 in King County Superior Court. In court papers, Virginia Mason argued that it had no legal duty to tell patients they could get the same services less expensively elsewhere.

But King County Judge Gregory Canova, who certified the case as a class action, rejected that argument.

John Phillips, lead attorney for the plaintiffs, said the settlement will give patients in the suit complete recovery of facility fee costs, though he did not specify a total amount.

It will also require Virginia Mason to provide information to patients in the future, "so they can make intelligent decisions about their health care — not just information about treatment options, but what the cost of treatment will be."

Sarah Patterson, executive vice president and hospital administrator for Virginia Mason, said the hospital settled because "our desire is to focus our energy on continuing to make improvements that will help our patients."

Patterson said Virginia Mason has already made improvements "in how we communicate to patients about billing, and additional enhancements will be made for the benefit of our patients."

She said patients who have questions regarding the settlement can call Virginia Mason's Patient Account Services Department at 206-223-6601.

A lawsuit over similar issues was filed against the University of Washington Medical Center earlier this year, after the Virginia Mason case was filed. That case was settled in September, with the UW agreeing to provide future patients with estimates of their out-of-pocket costs ahead of time.

Carol Ostrom: 206-464-2249 or costrom@seattletimes.com