Rupp v. Premier Health Partners
2025 Ohio 986
Ohio Ct. App.2025Background
- Two emergency-room patients (Rupp and Garrett) were treated at Miami Valley Hospital (MVH/Premier) by Dr. Kenneth Christman, an independent contractor who did not participate in private insurer networks and engaged in balance-billing and high charges.
- MVH had previously received complaints about Christman’s billing, briefly removed him from call, then reinstated him under 2010 independent-contractor agreements that required disclosure to patients, reasonable/compromised billing, and cooperation on collections (Section 5).
- After treatment MVH patients received large balance bills from Christman; insurers paid limited amounts and Christman sought the remainder, prompting collection threats and litigation.
- Plaintiffs sued Premier under the Ohio Consumer Sales Practices Act (CSPA) and sued Christman for fraud and breach of contract (asserting they were intended third‑party beneficiaries of MVH–Christman agreements); Christman counterclaimed for unpaid fees.
- Trial court granted summary judgment to Premier and Christman on many claims; on appeal the court affirmed summary judgment for Premier (CSPA) but reversed as to Christman on fraud and the intended third‑party‑beneficiary breach‑of‑contract claim, and remanded.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Premier violated the CSPA by failing to disclose Christman’s billing practices | Premier should have disclosed that Christman was an independent contractor, out‑of‑network, balance‑billed, and charged excessive/unreasonable fees | Premier had no duty to disclose independent‑contractor physician billing practices; in any event it provided disclosure via signs and registration consent forms and contract terms | Affirmed for Premier: no legal duty to disclose here; even assuming a duty, hospital provided notice and consent forms that put patients on notice |
| Whether Christman committed common‑law fraud by concealing billing practices and overcharging (including upcoding/unbundling) | Christman knowingly/ recklessly concealed material facts, made false representations about fees being reasonable, induced reliance, and caused injury | Christman contended he did not intend to mislead, EMTALA barred pre‑treatment financial disclosures, and plaintiffs suffered no injury because they hadn’t paid the bills | Reversed as to Christman: triable issues exist on concealment, materiality, justifiable reliance, falsity of fee representations, and actual malice; summary judgment on fraud improper |
| Whether plaintiffs are intended third‑party beneficiaries of the MVH–Christman independent‑contractor agreements (so may sue Christman for breach) | Contracts (esp. Section 5 and preamble) plainly intend to protect patients and require disclosure/reasonable fees; performance benefits patients — plaintiffs can enforce | Christman argued contracts didn’t apply to the emergency encounters or didn’t intend to benefit plaintiffs | Reversed as to Christman: contract language and context show plaintiffs are intended third‑party beneficiaries and triable breach issues remain |
| Whether plaintiffs lacked cognizable damages/injury because they had not paid Christman’s bills | Plaintiffs: they faced potential liability, collection actions, emotional distress, costs, and statutory noneconomic damages — so injury exists | Defendants: no injury because plaintiffs hadn’t actually paid the disputed balances | Court rejected defendants’ no‑injury argument as a basis for summary judgment; damages and rescission remain viable remedies for fraud/breach and other harms (triable issues) |
Key Cases Cited
- Celotex Corp. v. Catrett, 477 U.S. 317 (1986) (summary judgment procedure and burden allocation)
- Anderson v. Liberty Lobby, Inc., 477 U.S. 242 (1986) (summary judgment standard re genuine issues of material fact)
- Temple v. Wean United, Inc., 50 Ohio St.2d 317 (1977) (Ohio summary judgment standard)
- Moore v. Burt, 96 Ohio App.3d 520 (2d Dist. 1994) (hospital not automatically liable for acts of independent‑contractor doctors; limits on hospital duty to disclose)
- Browning v. Burt, 66 Ohio St.3d 544 (1993) (hospital vicarious liability and negligent‑credentialing principles)
- Clark v. Southview Hosp. & Family Health Ctr., 68 Ohio St.3d 435 (1994) (negligent‑credentialing framework for hospital liability)
- Blon v. Bank One, Akron, N.A., 35 Ohio St.3d 98 (1988) (duty to disclose in business transactions and Restatement §551 principles)
- Hill v. Sonitrol of Southwestern Ohio, Inc., 36 Ohio St.3d 36 (1988) (third‑party beneficiary test adopting Restatement §302)
- Grant Thornton v. Windsor House, Inc., 57 Ohio St.3d 158 (1991) (only parties or intended third‑party beneficiaries may enforce contracts)
- Burr v. Stark Cty. Bd. of Commrs., 23 Ohio St.3d 69 (1986) (elements of fraud and measure of damages)