A woman injured in a 2012 car crash
has dropped her lawsuit against an Evanston-based medical practice, after a
judge signed off on a settlement agreement ending the putative class action
litigation in which she had accused the doctors at the practice of wrongly
slapping liens on patients in an attempt to collect more than they should under
agreements with health insurers.
On Nov. 7, Cook County Judge Sophia H.
Hall approved the deal between plaintiff Barbara Niehus and Northshore
Physician Associates Inc.
Physician Associates Inc. formerly did business as NorthShore University Health
System Medical Group. State records indicate the president of NPA is Gerald
“J.P.” Gallagher. Gallagher serves as chief operating officer at NorthShore
University Health System, according to the health system’s website.
Collection agency First Recovery Group
LLC, of St. Peters, Mo., was also named as a defendant in the case, and was included in the
The judge’s order said the terms of
the settlement agreement are “confidential.” The order noted Niehus’ claims
were dismissed with prejudice, while the potential class action claims were
dismissed without prejudice.
Niehus was represented in the action
by attorney Daniel A. Edelman and the firm of Edelman Combs Latturner &
Goodwin, of Chicago.
Niehus had filed suit in June against
her former doctors, who had provided care to her in the years following a 2012 car
accident in which she was injured. According to the complaint, Niehus is a
participant in the HMO Illinois health insurance plan offered through Blue
Cross Blue Shield of Illinois.
The complaint said she had selected the NorthShore
Physician group as her primary care provider, under the terms of her HMO plan.
Further, the complaint said she believed NPA and
Blue Cross have a contract, common under such HMO plans, under which Blue Cross
pays NPA an agreed set monthly fee, rather than fees for services rendered for
patients covered by HMO Illinois.
And Niehus’ complaint said the terms of her plan
under HMO Illinois also stipulate that, should she require medical care because
she became ill or injured because of the actions or negligence of another
person, such as in a car crash, Blue Cross is entitled to collect reimbursements
from the other person for expenses paid for their insured’s medical care.
Further, the plan’s terms did not allow heath care providers, like NPA, to
pursue patients covered by HMO Illinois for further payment beyond what Blue
Cross paid them.
The lawsuit said Niehus said she believed NPA had
been fully paid for the care she received following her car crash, under the
terms of her HMO plan.
However, in January 2016, Niehus said she received a
letter from First Recovery Group, asserting it was collecting nearly $13,000
the physicians’ practice claimed it was owed for “medical benefits” provided to
Niehus. The letter demanded payment and asserted the debt collector would put a
lien on Niehus for a share of whatever she might collect in court from the
other driver involved in the crash.
Niehus said that lien is “inconsistent with the HMO
Illinois medical benefits plan in which (she) was enrolled at the time of the
accident,” as Blue Cross, “and not NPA, had the right to recover medical
payments from” the other driver.
Her lawsuit said she believes NPA has similarly
routinely placed liens on others like her, “because they believe that they will
recover more by placing a lien on the patient’s tort recovery than they
received as payments” under agreements with HMO plan providers.
The complaint specifically alleged NPA and First
Recovery violated the HMO contract, and committed consumer fraud.
NPA and First Recovery Group were
represented in the action by the firm of Winston & Strawn, of Chicago,
according to Cook County court records.