In the case, Vertlu Management employee Ronald Troyer underwent spine surgery at a HealthEast Care System hospital, which included a spinal cord stimulator implanted into his back. After the procedure, there was an 85 percent difference between the hospital’s usual charge for the spinal cord stimulator and the insurance company’s payment, leaving $37,822 unpaid.
State Auto, Mr. Troyer’s insurer, refused to pay the full amount to combat a steep price mark-up for implants, according to the report. However, the high court ruled that as the entity that furnished the implant, HealthEast was able to charge for the hardware.
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