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Insurer, Hospital Battle Over Transparency

May 4th, 2016 by flanews

A fight between auto-insurer State Farm and hospital UF Health Jacksonville (formerly Shands Jacksonville) could effect the wallets of patients around Florida. As Matt Galka tells us, State Farm wants to know if they’re paying too much to the healthcare provider – and the case went in front of the state’s Supreme Court Wednesday morning.

Are hospitals being truthful about their billing after car accidents? Insurance giant State Farm wants to know. The auto insurance company is battling UF Health Jacksonville – formerly Shands – over documents showing how much the hospital charges for services.  Auto-insurance companies pay hospitals under Florida’s Personal Injury Protection or PIP laws after accidents.

“Unreasonable charges would prematurely deplete the benefits of the insured,” said attorney Alan Nisberg.

The company argues that paying too much hurts the customer’s benefits – and too little could lead to rising premiums.

“If they pay a PIP claim that they think ‘ehhh, I don’t think this is a reasonable amount’ how are they then, procedurely,’ appropriately entitled to discover how that amount is reasonable?” asked Justice Ricky Polston.

“If they really question the reasonableness of this bill, which they didn’t we think by paying a year earlier, if they question in then they can either not pay it or pay the portion they think is appropriate,” said UF Health Jacksonville attorney John Tucker.

The case comes after the Governor started waging war with hospitals over price transparency.

We asked both sides to comment after the oral arguments concluded. State Farm attorney Alan Nisberg said he wasn’t authorized – while UF Health Jacksonville attorney John Tucker said it’s now up to the justices.A circuit judge has already ruled in favor of State Farm, with the first district court of appeals siding with UF Health Jacksonville

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