Commercial Law World - Issue 4, 2017 - 24

However, the assertion presented by the patient is that
because the hospital takes insurance, and that the insurance
pays less, then the insurance rate is actually what the charge
should be. This is meritless.
In Huntington Hospital v. Abrandt, 4 Misc 3d 1, 779
NYS2d 891 (9th & 10 Judicial Districts), the Court held
that absent any insurance coverage, or governmental
statute, a Patient's allegation that a charge is too high, is not
a meritorious defense, stating, "The fact that lesser amounts
for the same services may be accepted from commercial
insurers or governmental programs as payment in full does
not indicate that the amounts charged to patient were not
reasonable..." In Albany Medical Center Hospital v. Huberty,
76 A.D.2d 949, 428 N.Y.S.2d 746 (N.Y.A.D.,1980), the
Court held that the mere fact that the hospital chooses to
contract with insurance carriers for lesser rates, does not
preclude the hospital from seeking the full rate of payment
from the patient. In Flushing Hospital and Medical Center
v. Woytisek, 41 N.Y.2d 1081, 396 N.Y.S.2d 349 (N.Y. 1977),
the Court held that an insurance carrier is entitled to
"what amounts to a very substantial discount with respect
to its 50% of the regular charges..." However, the patient
"is not entitled to derive any economic benefit from this
independent arrangement..."

The logical reasoning
is essentially that if a
customer went to a car
dealership to buy a car,
they are paying the full
"sticker price".
If the customer was a small business looking to buy five
cars from that same dealership, the customer will likely get
a better deal, as it has more buying power. However, if the
customer was a national car rental chain, and wanted two
hundred cars, you could be certain that the customer would
get a significant discount.
That is what an insurance carrier essentially negotiates
with a medical provider. By being part of the insurance
network, the provider receives more patients, and that
"buying power" does not change the rate, but rather, the
provider contractually chooses to accept a lower payment.
24 COMMERCIAL LAW WORLD

"I Didn't Need Those Services!"
Unfortunately, some patients look to have 20/20
hindsight, or play "Monday Morning Quarterback."
The assertion is that since the tests run did not result in
the diagnosis of some dire ailment, then the tests were
unnecessary. This is an invalid assertion.
In Long Island Jewish Medical Center v. Budhu 20 Misc.3d
131(A), 867 N.Y.S.2d 17 (N.Y.Sup.App.Term,2008), the
Court held that, "Although defendant made the bald,
conclusory statement that the medical services rendered
were unnecessary, in the absence of competent expert
medical proof supporting defendant's contention, the
opposition papers were insufficient to raise a triable issue of
fact to defeat the motion for summary judgment..."

"That Isn't My Bill!"
The fourth myth to dispel is that a spouse is not
responsible for their other spouse, and that the parents of
a child, who is generally between the ages of 18 and 21, are
not responsible.
Let us first turn to spousal responsibility. A patient is
bound by the common-law doctrine of necessaries. As is
well-settled by the common law doctrine of necessaries,
a spouse is responsible for its spouse's necessary debts.
Medical bills have unequivocally been found to be one such
necessary. Medical Business Associates, Inc. v. Steiner, 183
A.D.2d 86, 588 N.Y.S.2d 890, (App. Div. 2d 1992); Our
Lady of Lourdes Memorial Hospital v. Frey, 548 N.Y.S.2d 109
(App. Div. 3d 1989).
As far as minors, the Family Court Act, 413(1)(a)
imposes a statutory obligation upon parents of children
under 21 years of age to provide support for such children,
which necessarily includes medical bills, such as these.
Hudson Valley Neonatology PC v. Salem, NYLJ 12/14/00 at
32, col 1, (App. Term 9th and 10th Jud. Dists).
In the absence of proof of emancipation, the statutory
duty to provide for such services is absolute. Albany Medical
Center Hosp. v. Johnston, 102 A.D.2d 915, 477 N.Y.S.2d
499 (3d Dept 1984); Clough v. Board of Ed. of Spencerport
Central School Dist., Monroe County, 56 A.D.2d 233, 392
N.Y.S.2d 170 (4th Dept 1977); Mary Imogene Bassett
Hospital v. Dahlberg, 229 A.D.2d 781, 645 N.Y.S.2d 578
(3d Dept. 1996); Radcliffe v. Hofstra University, 200 A.D.2d
562, 606 N.Y.S.2d 333 (2d Dept. 1994). Such duty pertains,
regardless of whether or not the parent signed as guarantor.
These four myths are perpetrated nearly every day in
New York, and I would bet that similar myths pop up in
every jurisdiction. 
OCT /NOV /DEC 2017



Table of Contents for the Digital Edition of Commercial Law World - Issue 4, 2017

Contents
Commercial Law World - Issue 4, 2017 - Cover1
Commercial Law World - Issue 4, 2017 - Cover2
Commercial Law World - Issue 4, 2017 - Contents
Commercial Law World - Issue 4, 2017 - 2
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Commercial Law World - Issue 4, 2017 - 4
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Commercial Law World - Issue 4, 2017 - Cover3
Commercial Law World - Issue 4, 2017 - Cover4
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