AG SECURES $260,000 FROM SOUTH SHORE ANESTHESIA PROVIDER TO SETTLE ALLEGED UNFAIR “SURPRISE BILLING” PRACTICES

AG SECURES $260,000 FROM SOUTH SHORE ANESTHESIA PROVIDER TO SETTLE ALLEGED UNFAIR “SURPRISE BILLING” PRACTICES

Medical Group Agrees to Stop Billing or Collecting on “Surprise Bills”

 

            BOSTON – South Shore Anesthesia Associates (SSAA), a Weymouth-based provider of anesthesia and pain management care, will pay $260,000 to settle allegations of “surprise billing” practices, Attorney General Maura Healey announced today.

 

In an assurance of discontinuance filed on Tuesday in Suffolk Superior Court, SSAA settled the AG’s allegations that it violated the Massachusetts consumer protection law by failing to adequately disclose to certain patients that SSAA was out of network with those patients’ health plans and then seeking to collect unfairly high charges from the patients.

 

“Massachusetts residents have a right to transparency when it comes to their health care and should not be subjected to surprise billing practices when seeking medical care,” said AG Healey. “Health care providers should take the appropriate steps to provide consumers with adequate information to allow them to make informed health care decisions and avoid unexpected charges.”

 

This settlement is the result of an investigation initiated by the AG’s Office after receiving consumer complaints from individuals who sought health care at South Shore Hospital, an in-network provider for them. After receiving a bill, the patients found out for the first time that SSAA, the anesthesia provider at South Shore Hospital, was out of network and that they were being charged significantly more than they would have been charged for an in-network anesthesia provider.

 

SSAA, which ceased providing clinical services in June 2020 and is in the process of closing its practice, will pay a total of $260,000, including a $185,000 civil penalty, to the state under the terms of the settlement.

 

Additionally, SSAA has agreed to:

 

• stop billing for and collecting on any remaining balances for patient accounts involving out of network services or uninsured patients, and forgive the debts incurred by such patients;
• inform any outside collection agencies it has used that debts incurred by these patients have been satisfied; and
• take all necessary steps to have these patients’ accounts removed from any applicable credit report and credit reporting agency.

 

The investigation and settlement are part of the AG’s ongoing examination of how increased transparency can help consumers avoid unexpected charges. As part of this effort, in September 2018, the AG’s Office settled with Partners HealthCare System Inc., requiring it to provide patients important information concerning billing practices at hospital outpatient locations and urgent care centers.

 

If consumers have questions or concerns about their health insurance claims or medical bills, they can contact the AG’s Health Care Helpline at (888) 830-6277 or file a complaint here.

 

This matter was handled by Assistant Attorney General Lisa Gaulin, Paralegal Troy Brown, and Mediator Pat Hamilton, with assistance from Division Chief Eric Gold, all of the AG’s Health Care Division.