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Biddle v. Warren General Hospital9/15/1999
Submitted March 30, 1999
Sometime prior to 1993, appellant and cross-appellee Robert L. Heller, a shareholder in appellant and cross-appellee Elliott, Heller, Maas, Moro & Magill Co., L.P.A. ("the law firm"), attended a legal seminar, where he got the idea that the law firm could assist a hospital in determining whether unpaid medical bills could be submitted to the Social Security Administration for payment. Upon his return, Heller proposed this idea to Rush Elliott, president of the law firm and, at that time, a trustee of Warren General Hospital Foundation and president of Warren General Hospital Health Systems. Elliott asked Mark Tierney, then chief financial officer of appellant and cross-appellee Warren General Hospital ("the hospital"), to meet with Heller.
In early 1993, a meeting was held resulting in an unwritten agreement under which, according to Tierney, " he law firm would screen potential candidates for SSI [Supplemental Security Income] eligibility and contact those patients on the hospital's behalf as to their rights to apply for SSI Disability, thus having their medical claim covered under SSI and the hospital could, therefore, receive payment for services that it provided that it would otherwise have to write-off as an uncollect ble account, and in return for those services, upon payment from SSI, the hospital would pay a contingency fee to Elliott, Heller & Maas."
Heller informed the hospital that in order for the law firm to perform this service, it would be necessary for the hospital to provide four pieces of information with regard to each patient to be screened: name, telephone number, age, and medical condition. Accordingly, a joint decision was made to provide the law firm with the hospital's patient registration forms.
Over the next two and one-half years, the hospital released all of its patient registration forms to the law firm without obtaining any prior consent or authorization from its patients to do so, and without prescreening or sorting them in any way. The law firm sent a courier to the hospital on a weekly basis to retrieve the forms and bring them back to its office, where they were reviewed by Heller and Sharyn Jacisin, a legal assistant employed by the law firm, and separated according to potential SSI eligibility. The forms of those patients whom the law firm determined not to be eligible for disability benefits were put in a cardboard box and eventually placed in storage, and nothing further was done on those accounts.
Those patients who were considered potential candidates for SSI were telephoned by either Jacisin or Melanie Sutton, who at that time was Heller's secretary. According to the law firm, neither Jacisin nor Sutton indicated where they worked, but instead stated that they were calling on behalf of the hospital and that "you might be entitled to Social Security benefits that might help you pay your medical bill." Those patients who showed interest were referred to Heller. Jacisin testified at deposition that she made approximately one hundred of these phone calls, the purpose of which was to make an appointment to see if those patients were eligible for Social Security benefits.
Heller testified that he met with only " robably 5" individuals, that he "absolutely not" tell them that he or his law firm would represent them in making application for benefits, but that these individuals did retain him, without any discussion of compensation, "to help them get their benefits so their medical bills could get paid." However, Elliott testified that it "was more or less the understood agreement * * * between the firm and the hospital" that the hospital was the initial client of the
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