Liberty HealthShare sued by members seeking reimbursement


Jackson Township Christian organization, one of the nation’s largest health-sharing ministries, is sued by four out-of-state members who claim Liberty HealthShare has made a killing misrepresentation, sold illegal health insurance, and funneled money that was supposed to help pay people’s medical bills. to its leaders, their friends and their families.

Learn more about Liberty HealthShare: Liberty HealthShare once again a major sponsor of the annual CPAC event

All four Liberty HealthShare members – current member William Rooker from Maryland and former members Rochelle Glasgow from Montana, Donna Landry from Washington and Bonnie Martin from Maryland – are seeking class action status for the federal lawsuit that was filed in October in the northern district of the United States. Ohio Court. If granted, the lawsuit could include all current and former members of Liberty, which incorporated in 2014 and served more than 70,000 families nationwide in 2020.

Ohio Attorney General Dave Yost, whose office is responsible for regulating Ohio nonprofits such as Liberty, is listed as a nominal plaintiff in the 70-page lawsuit.

In addition to Liberty HealthShare, the lawsuit names 10 people as defendants:

  • Druzilla “Drudy” Abel and Dale E. Bellis, who are two of the founders of Liberty, and Matt Bellis, who is an executive of Liberty.
  • Daniel Beers Jr., Brandon Fabris and Ronald Beers, who are directors of Cost Sharing Solutions, a Jackson Township-based company that manages marketing, telemarketing, design and call center services. The company has also partnered with Liberty as a sponsor of the Conservative Political Action Conference.
  • Thomas Fabris, owner of Medical Cost Savings Solution, which is a Jackson Township company that offers claims pricing, balancing bill defense, and legal assistance to self-paid patients.
  • Douglas Behrens, former director of a trading company that predated Liberty and owner of SavNet International, which is a drugstore and prescription rebate program in Fairlawn.
  • Daniel J. Beers Sr., Benjamin “Bennie” Beers, Rachel Beers and Pamela K. Johnson who are close to the founders of Liberty or the leaders of the three service providers.

The two central allegations in the lawsuit are: that Liberty sold and administered illegal health insurance under the guise of a faith-based shared health care ministry in order to avoid paying taxes and government oversight state and federal. And that Liberty officials used membership dues to pay inflated service costs to businesses operated by friends and relatives instead of using the money to pay for members’ medical expenses, leaving members obligated to pay. themselves large medical bills.

The lawsuit also questions whether those named in the lawsuit engaged in mail or email fraud, broke federal laws regarding racketeering activity, and broke rules allowing nonprofits to maintain their status as tax exemption.

Represented by attorneys in Kent, Georgia and California, the four members seek a declaration that Liberty’s health plans are unauthorized health insurance and illegal contracts; the removal and replacement of Liberty’s board of directors and appointed employees; and reimbursement of money members have paid for services not rendered, as well as damages, litigation costs and other expenses.

Liberty HealthShare defends itself

In an email Friday night, a representative for Liberty HealthShare called the lawsuit allegations “false or inaccurate.”

Terrie Ipson, vice president of marketing and communications, wrote in an email that Liberty is a shared health care ministry, as outlined in the Affordable Care Act and the laws of more than 30 states.

“We are following the rules set for shared health care ministries,” she said.

Ipson said Liberty would not discuss the details of the lawsuit, but added that Liberty is not, and never has been, an insurance company.

“He doesn’t sell health insurance policies,” Ipson wrote. “Separate from Medicare, we provide our members with the power to share the costs of health care with one another through denominational donations. “

Lawyer Laura Mills, of Mills, Mills, Fiely & Lucas, who represents Cost Sharing Solutions, Medical Cost Savings Solution and some of those named in the case, wrote in a statement that the lawsuit is primarily directed against Liberty by four members who do not specify any actual damage in the complaint as a result of their Liberty membership.

Mills said the companies she represents are private sector suppliers and will continue to serve Liberty under existing contracts pending the dismissal of the lawsuit.

“It is unfortunate that family members who have no connection or relationship to Liberty, MCS or CSS have been named accused, but it certainly demonstrates the lack of factual basis for the complaint,” Mills said in the statement sent. by e-mail. “On behalf of MCS, CSS and its owners, we look forward to providing their version of these allegations in the months to come and through the appropriate channel which is our legal system.”

The lawyers who filed the complaint did not return a message seeking comment. Glasgow, who was a member of Liberty from 2017 to May, declined to comment.

A message left at Yost’s office was not returned.

Claim: Liberty HealthShare is not a legitimate healthcare sharing ministry

The lawsuit accuses Liberty of misleading members by saying it was a legitimate shared health care ministry.

Health care sharing ministries, also known as health sharing, are alternatives to traditional health insurance. Healthshare members – usually those of the same religious faith – make monthly payments which are pooled and then used to cover eligible medical bills for other members of the group.

Because they are not insurance companies, healthshares is not obligated to cover a member with a pre-existing condition and may deny coverage for medical claims that do not match healthshare’s mission of faith.

The popularity of health care shares exploded after 2010, when Congress declared people in a health care sharing ministry exempt from the Health Care Act health insurance coverage requirement. affordable.

Liberty, which employs around 470 people in its two offices on Fulton Drive NW and Hills and Dales Road NW, promotes itself as a voluntary association of like-minded people who come together to help each other by sharing medical expenses. She is affiliated with the Gospel Light Mennonite Church in Virginia.

Learn more about Liberty Healthshare in court: Liberty HealthShare, former employees file a complaint

According to its most recent nonprofit filing, Liberty paid $ 352 million in medical bills for its members.

The record also states that Liberty is legally recognized by the Centers for Medicare and Medicaid Services as a shared health care department.

But the lawsuit argues that Liberty is not a shared health care ministry at all.

Lawyers argue Liberty is not considered a shared health care department under federal law (the Internal Revenue Code) or for the Affordable Care Act exemption because it was created after on December 31, 1999, with no qualifying predecessor entity and because it didn’t limit its membership based on faith.

For the purposes of the ACA exemption, the federal definition of a shared health care department states that the nonprofit organization must have been in existence since December 31, 1999, and that the members of the department share a common set. ethical or religious beliefs.

The lawsuit also points out that Virginia’s definition of a shared health care ministry states that the arrangement must be made between people of the same religion on the basis of their sincere religious beliefs and that the ministry must limit its members. to people of the same faith.

He says Liberty does not have a process for verifying the sincere and shared religious beliefs of applicants or members.

Ohio does not have laws that specifically identify health sharing groups as not being in the insurance business.

In a 2019 interview, Larry Foster, then CEO of Liberty, told the Canton Repository that Liberty members are not required to be affiliated with a church, but are encouraged to attest to their Christian beliefs.

Liberty’s website says it started in 1995, but incorporated in Ohio as Liberty HealthShare in 2014.

Allegation: Member payments were not used correctly

Liberty members, like other Healthshare members, must make monthly contributions, which are similar to premiums for traditional health insurance users, to obtain coverage for themselves and their families.

Liberty, whose operations are overseen by a six-member board of directors, must use these monthly dues to pay members’ eligible medical expenses and cover administrative costs.

But lawsuit alleges Liberty officials eroded the amount of money available to pay for members’ medical expenses when they paid above-market prices for services provided by Cost Sharing Solutions, Medical Cost Savings Solution, and SavNet International. .

The lawsuit also claims that Liberty’s dispute resolution procedures were designed and used by Liberty to wrongly delay and deny covered claims.

As the Repository first reported in 2019, Liberty has faced a growing number of complaints from members who have accused the company of failing to pay qualified medical claims, of misrepresenting themselves. and provide poor service.

As of this week, the Ohio attorney general’s office has filed 288 complaints against Liberty, including 286 since March 2019. The most recent was filed on November 29.

According to the Better Business Bureau website, 1,114 complaints about Liberty had been filed in early November.

Canton Repository editor-in-chief Edd Pritchard contributed to this article.

Contact Kelli at 330-580-8339 or [email protected]

On Twitter: @kweirREP


Source link

Previous Josette Rizk, Director of Institutional Clients, MEA, Invesco
Next "Things are really tough right now:" Rising prices make it harder for some families to buy holiday gifts