Jackson v. Professional Radiology Inc, 1:15-cv-00587

Plaintiff Barbara Jackson was treated by Professional Radiology after a 2014 auto accident and had UnitedHealthcare insurance; provider did not bill UnitedHealthcare.
Professional Radiology uses M.D. Business Solutions for billing; unpaid balance was referred to Controlled Credit Corporation (CCC).
Jackson paid CCC $852 in full settlement and later paid an additional $3.49 after a renewed contact.
Jackson sued on behalf of a putative class alleging violations arising from direct billing patients despite insurance, asserting claims including breach of contract, OCSPA, FDCPA, fraud, conversion, unjust enrichment, and punitive damages.
Central legal question: whether Ohio Rev. Code § 1751.60(A) bars a provider from seeking payment from an insured patient when the provider contracts with the patient’s health insurer but did not seek compensation from the insurer under that contract.
District court granted motions to dismiss/judgment on the pleadings for all defendants, holding § 1751.60(A) did not apply because defendants did not seek payment under the contract with the insurer.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether § 1751.60(A) bars provider from billing insured patient when provider contracts with insurer	§ 1751.60(A) prohibits billing the insured and requires seeking payment solely from the insurer	§ 1751.60(A) applies only where provider seeks compensation under the provider–insurer contract; not implicated here	Court: statute inapplicable because defendants did not seek compensation under the contract, so no violation
Whether complaint states plausible claims dependent on statutory violation	Jackson contends statutory violation supports her multiple causes of action	Defendants move to dismiss / judgment on pleadings arguing statute not violated, so claims fail	Court: claims dismissed for failure to state a claim because statutory prerequisite absent
Whether prior Ohio Supreme Court precedent controls interpretation of § 1751.60	Jackson argues the statute bars direct billing regardless of whether insurer was billed	Defendants rely on King v. ProMedica to limit application to claims under provider–insurer contract	Court: bound by King; follows King’s limiting construction
Procedural: whether supplemental authority and response accepted	Plaintiff filed supplemental authority; defendants sought to strike or be allowed to respond	Defendants requested relief to respond to supplemental authority	Court granted defendants leave to file response; response considered

King v. ProMedica Health Sys., Inc., 955 N.E.2d 348 (Ohio 2011) (§ 1751.60(A) applies only when provider seeks compensation under provider–insurer contract)
Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007) (plausibility standard for pleadings)
Ashcroft v. Iqbal, 129 S. Ct. 1937 (2009) (legal conclusions not accepted as true for plausibility review)
Bassett v. National Collegiate Athletic Ass'n, 528 F.3d 426 (6th Cir. 2008) (motion to dismiss standard: construe complaint favorably)
Fritz v. Charter Township of Comstock, 592 F.3d 718 (6th Cir. 2010) (Rule 12(c) standard same as Rule 12(b)(6))