Summary
The Louisiana Second Circuit Court of Appeal affirmed dismissal of Kimberly Pearson Ruby’s claims against her chiropractor under the Health Care Consumer Billing and Disclosure Protection Act, also known as the Balanced Billing Act, and the Louisiana Unfair Trade Practices Act. The court held that the evidence did not establish double billing, improper collection, or unfair trade practices, and found no manifest error in the trial court’s factual findings.
Topics
Practice areas
Questions Presented
- Whether the trial court manifestly erred in finding that Carpenter did not violate the Balanced Billing Act by billing State Farm and seeking payment of the remaining chiropractic charges.
- Whether Carpenter's billing conduct violated the Louisiana Unfair Trade Practices Act.
- Whether Ruby was entitled to damages, treble damages, attorney fees, or other relief under the Balanced Billing Act or LUTPA.
Holdings
- The trial court did not manifestly err in finding that Carpenter did not violate the Balanced Billing Act. The evidence showed that Carpenter did not double bill an insurance provider, billed State Farm at Ruby's direction, and did not know of the Blue Cross Blue Shield coverage until after treatment had ended and the billing dispute had arisen.
- Carpenter did not violate LUTPA because the evidence did not establish fraud, deception, misrepresentation, breach of fiduciary duty, or other unethical conduct, and the trial court's factual determination was not manifestly erroneous.
- Ruby was not entitled to damages, treble damages, attorney fees, or other relief because she failed to establish a violation of either the Balanced Billing Act or LUTPA.
Key quotations
“The BBA, La. R.S. 22:1871, et seq., prohibits a contracted healthcare provider from collecting or attempting to collect amounts from an insured patient in excess of the contracted reimbursement rate.” (4)
“The evidence shows Defendant never attempted to double bill any insurance provider.” (7)
Factual background
Ruby received chiropractic treatment from Carpenter after a March 9, 2019 automobile accident. Her initial treatment was billed to United Healthcare at an in-network contractual rate; after that coverage ended, she instructed Carpenter to bill State Farm, the tortfeasor's insurer, and Carpenter filed a medical lien and billed State Farm. Ruby later obtained Blue Cross Blue Shield coverage effective October 1, 2019, but the trial court found Carpenter did not learn of that coverage until September 3, 2020, after treatment and settlement-related billing had ended. Carpenter billed a total of $7,585, received $5,365 from the settlement, and Ruby later paid the remaining $2,220 under protest.
Procedural history
Ruby was treated by Carpenter after an automobile accident and sued, alleging that Carpenter improperly billed the tortfeasor's insurer rather than her later-obtained health insurer and thereby violated the Balanced Billing Act and LUTPA. After a bench trial on October 21, 2024, the trial court found no unlawful double billing, no failure to participate in discount billing, no fraud, and no unfair trade practice. The trial court issued reasons on February 7, 2025, entered judgment dismissing the suit with prejudice on April 11, 2025, and Ruby appealed.