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Raymond v. Avectus Healthcare Solutions, LLC

United States Court of Appeals, Sixth Circuit

June 12, 2017

Keith Raymond; Timothy Strunk, individually and on behalf of all others similarly situated, Plaintiffs-Appellants,
v.
Avectus Healthcare Solutions, LLC; Mercy Health, Defendants-Appellees.

          Argued: April 27, 2017

         Appeal from the United States District Court for the Southern District of Ohio at Cincinnati. No. 1:15-cv-00559-Michael R. Barrett, District Judge.

         ARGUED:

          Gary F. Franke, GARY F. FRANKE CO. LPA, Cincinnati, Ohio, for Appellants.

          Ronald D. Holman II, TAFT STETTINIUS & HOLLISTER LLP, Cleveland, Ohio, for Appellee Avectus. Kris M. Dawley, ICE MILLER LLP, Columbus, Ohio, for Appellee Mercy.

         ON BRIEF:

          Gary F. Franke, Michael D. O'Neill, GARY F. FRANKE CO. LPA, Cincinnati, Ohio, C. David Ewing, EWING & WILLIS, PLLC, Louisville, Kentucky, for Appellants.

          Ronald D. Holman II, Michael J. Zbiegien, Jr., TAFT STETTINIUS & HOLLISTER LLP, Cleveland, Ohio, Chad R. Ziepfel, TAFT STETTINIUS & HOLLISTER LLP, Cincinnati, Ohio, for Appellee Avectus. Kris M. Dawley, John P. Gilligan, Mary F. Geswein, ICE MILLER LLP, Columbus, Ohio, for Appellee Mercy.

          Before: MERRITT, BATCHELDER, and CLAY, Circuit Judges.

          OPINION

          ALICE M. BATCHELDER, Circuit Judge.

         Appellants and purported class plaintiffs, Keith Raymond and Timothy Strunk, were injured in separate accidents and were both treated by Appellee Mercy Health. Even though Raymond and Strunk have health insurance, Mercy Health did not submit their medical bills to their respective health insurance carriers. Instead, Mercy Health and its debt collector, Appellee Avectus Healthcare Solutions, sought payment from any tort settlement or award Raymond and Strunk would receive. The district court determined that this conduct did not violate Ohio Revised Code § 1751.60. Because we disagree, we REVERSE and REMAND for further proceedings not inconsistent with this opinion.

         I.

         In February 2015, Raymond was injured in a slip-and-fall accident, and he received medical treatment at Mercy Health Anderson Hospital. In June 2013, Strunk was injured in a car accident, and he received medical treatment at Mercy Health Clermont Hospital. Raymond and Strunk both have health insurance, and each of their health insurance carriers has an agreement with Mercy Health for the provision of services.[1] Raymond and Strunk provided to Mercy Health all relevant information necessary for the hospital to submit claims for coverage. Mercy Health, however, did not submit the claims to Raymond's and Strunk's health insurance providers.

         Instead, Avectus, on behalf of Mercy Health, sent letters[2] to Raymond's and Strunk's attorneys stating the balance due for medical services and requesting that, in order to prevent collection efforts against their ...


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