The California attorney general’s office is suing a Los Angeles County doctor over her practice of refusing to accept lower insurance company reimbursements and instead billing patients for the full amount.
The lawsuit against South Pasadena physician Jeannette Martello is the first of its kind in the state, the Los Angeles Times reported Saturday.
The California Medical Board is also moving to revoke Martello’s license over the same issue, known as “balance billing,” which is illegal.
Martello’s attorney Andrew Selesnick said the doctor has done nothing wrong and she is lawfully pursuing her right to be paid a fair amount for her services.
A judge in May ordered Martello to stop her aggressive tactics, including lawsuits and liens on homes, to force patients to pay for emergency care when they were covered under managed-care health insurance plans.
According to state law, that is illegal because emergency room patients have little say in who treats them. Under a 2009 California Supreme Court decision, payment disputes are supposed to be settled between the health insurer and the physician, and not involve the patient.
Selesnick said that even though Martello was treating patients in the emergency room, the patients were in stable condition. Because it was not emergency treatment, she was allowed to bill them for the amount insurance companies would not cover, he told the Times.
Court records show Martello has filed more than 50 lawsuits in the past two years, mostly for breach of contract. In one case, she started the process to force the sale of a patient’s home to pay a $12,630 bill for emergency room treatment of a severed fingertip.
In that case, Martello sent back a $3,500 insurance check and then sued patient Bill Buck, his wife and his business for the full amount.
In another case, Martello took a patient’s mother to small claims court for a $2,000 bill and lost. She then filed a lien on Nancy Hauser’s home to recoup “post judgment costs” and again lost.
The California Medical Board is also basing its petition to revoke Martello’s license because she requires emergency patients to sign agreements stating that they are liable for the full amount of her fees if they not covered by the insurer.
Huntington Memorial Hospital, where Martello worked as a contract emergency room doctor, no longer employs her, the hospital told the Times.
The state attorney general’s lawsuit seeks to stop Martello’s billing collection policies and to have her pay back the patients.