Lose Weight, Gain Huge Debt: NY Provider Has Sued More Than 300 Patients Who Had Bariatric Surgery

Published

2 years ago

April 21, 2023

admin

Seven months after Lahavah Wallaces weight loss operation, a New York bariatric surgery practice sued her, accusing her of intentionally failing to pay nearly $18,000 of her bill.

This story also ran on CBS News. It can be republished for free.

Long Island Minimally Invasive Surgery, which does business as the New York Bariatric Group, went on to accuse Wallace of embezzlement, alleging she kept insurance payments that should have been turned over to the practice.

Wallace denies the allegations, which the bariatric practice has leveled against patients in hundreds of debt-collection lawsuits filed over the past four years, court records in New York state show.

In about 60 cases, the lawsuits demanded $100,000 or more from patients. Some patients were found liable for tens of thousands of dollars in interest charges or wound up shackled with debt that could take a decade or more to shake. Others are facing the likely prospect of six-figure financial penalties, court records show.

Backed by a major private equity firm, the bariatric practice spends millions each year on advertisements featuring patients who have dropped 100 pounds or more after bariatric procedures, sometimes having had a portion of their stomachs removed. The ads have run on TV, online, and on New York City subway posters.

The online ads, often showcasing the slogan Stop obesity for life, appealed to Wallace, who lives in Brooklyn and works as a legal assistant for the state of New York. She said she turned over checks from her insurer to the bariatric group and was stunned when the medical practice hauled her into court citing an out-of-network payment agreement she had signed before her surgery.

I really didnt know what I was signing, Wallace told KFF Health News. I didnt pay enough attention.

Dr. Shawn Garber, a bariatric surgeon who founded the practice in 2000 on Long Island and serves as its CEO, said that prior to rendering services his office staff advises patients of the costs and their responsibility to pay the bill.

The bariatric group has cited these out-of-network payment agreements in at least 300 lawsuits filed against patients from January 2019 through 2022 demanding nearly $19 million to cover medical bills, interest charges, and attorneys fees, a KFF Health News review of New York state court records found.

Danny De Voe, a partner at Sahn Ward Braff Koblenz law firm in Uniondale, New York, who filed many of those suits, declined to comment, citing attorney-client privilege.

In most cases, the medical practice had agreed to accept an insurance companys out-of-network rate as full payment for its services with caveats, according to court filings.

In the agreements they signed, patients promised to pay any coinsurance, meeting any deductible, and pass on to the medical practice any reimbursement checks they received from their health plans within seven days.

Patients who fail to do so will be held responsible for the full amount charged for your surgery, plus the cost of legal fees, the agreement states.

That full amount can be thousands of dollars higher than what insurers would likely pay, KFF Health News found while legal fees and other costs can layer on thousands more.

Elisabeth Benjamin, a lawyer with the Community Service Society of New York, said conflicts can arise when insurers send checks to pay for out-of-network medical services to patients rather than reimbursing a medical provider directly.

We would prefer to see regulators step in and stop that practice, she said, adding it causes tension between providers and patients.

Thats certainly true for Wallace. The surgery practice sued her last August demanding $17,981 in fees it said remained unpaid after her January 2022 laparoscopic sleeve gastrectomy, an operation in which much of the stomach is removed to assist weight loss.

The lawsuit also tacked on a demand for $5,993 in attorneys fees, court records show.

The suit alleges Wallace signed the contract even though she had no intention of paying her bills. The complaint goes on to accuse her of committing embezzlement by willfully, intentionally, deliberately and maliciously depositing checks from her health plan into her personal account.

The suit doesnt include details to substantiate these claims, and Wallace said in her court response they are not true. Wallace said she turned over checks for the charges.

They billed the insurance for everything they possibly could, Wallace said.

In September, Wallace filed for bankruptcy, hoping to discharge the bariatric care debt along with about $4,700 in unrelated credit card charges.

The medical practice fired back in November by filing an adversary complaint in her Brooklyn bankruptcy court proceeding that argues her medical debt should not be forgiven because Wallace committed fraud.

The adversary complaint, which is pending in the bankruptcy case, accuses Wallace of fraudulently inducing the surgery center to perform elective medical procedures without requiring payment upfront.

Both the harsh wording and claims of wrongdoing have infuriated Wallace and her attorney, Jacob Silver, of Brooklyn.

Silver wants the medical practice to turn over records of the payments received from Wallace. There is no fraud here, he said. This is frivolous. We are taking a no-settlement position. A bariatric surgery practice sued Lahavah Wallace last August demanding $17,981 in fees it said remained unpaid after her January 2022 laparoscopic sleeve gastrectomy.(Jackie Molloy for KFF Health News)

Gaining Debt

Few patients sued by the bariatric practice mount a defense in court and those who do fight often lose, court records show.

The medical practice won default judgments totaling nearly $6 million in about 90 of the 300 cases in the sample reviewed by KFF Health News. Default judgments are entered when the defendant fails to respond.

Many cases either are pending, or it is not clear from court filings how they were resolved.

Some patients tried to argue that the fees were too high or that they didnt understand going in how much they could owe. One woman, trying to push back against a demand for more than $100,000, said in a legal filing that she was given numerous papers to sign without anyone of the staff members explaining to me what it actually meant. Another patient, who was sued for more than $40,000, wrote: I dont have the means to pay this bill.

Among the cases described in court records: A Westchester County, New York, woman was sued for $102,556 and settled for $72,000 in May 2021. She agreed to pay $7,500 upon signing the settlement and $500 a month from September 2021 through May 2032. A Peekskill, New York, woman in a December 2019 judgment was held liable for $384,092, which included $94,047 in interest. A Newburgh, New York, man was sued in 2021 for $252,309 in medical bills, 12% interest, and $84,103 in attorneys fees. The case is pending.

Robert Cohen, a longtime attorney for the bariatric practice, testified in a November 2021 hearing that the lawyers take a contingency fee of one-third of our recovery in these cases. In that case, Cohen had requested $13,578 based on his contingency fee arrangement. He testified that he spent 7.3 hours on the case and that his customary billing rate was $475 per hour, which came to $3,467.50. The judge awarded the lower amount, according to a transcript of the hearing.

Dr. Teresa LaMasters, president of the American Society for Metabolic and Bariatric Surgery, said suing patients for large sums is not a common practice among bariatric surgeons.

This is not what the vast majority in the field would espouse, she said.

But Garber, the NYBGs chief executive, suggested patients deserve blame.

These lawsuits stem from these patients stealing the insurance money rather than forwarding it onto NYBG as they are morally and contractually obligated to do, Garber wrote in an email to KFF Health News.

Garber added: The issue is not with what we bill, but rather with the fact that the insurance companies refuse to sendpayment directly to us. Email Sign-Up

Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up

A Kooky System

Defense attorneys argue that many patients dont fully comprehend the perils of failing to pay on time for whatever reason.

In a few cases, patients admitted pocketing checks they were obligated to turn over to the medical practice. But for the most part, court records dont specify how many such checks were issued and for what amounts or whether the patient improperly cashed them.

Its a kooky system, said Paul Brite, an attorney who has faced off against the bariatric practice in court.

You sign these documents that could cost you tons of money. It shouldnt be that way, he said. This can ruin their financial life.

New York lawmakers have acted to limit the damage from medical debt, including surprise bills.

In November, Democratic Gov. Kathy Hochul signed legislation that prohibits health care providers from slapping liens on a primary residence or garnishing wages.

But contracts with onerous repayment terms represent an evolving area of law and an alarming new twist on concerns over medical debt, said Benjamin, the community service society lawyer.

She said contract accelerator clauses that trigger severe penalties if patients miss payments should not be permitted for medical debt.

If you default, the full amount is due, she said. This is really a bummer. Online ads for bariatric surgery appealed to Lahavah Wallace. She said she turned over checks from her insurer to the New York Bariatric Group and was stunned when the medical practice hauled her into court citing an out-of-network payment agreement she had signed before her surgery.(Jackie Molloy for KFF Health News)

Fair Market Value

The debt collection lawsuits argue that weight loss patients had agreed to pay fair market value for services and the doctors are only trying to secure money they are due.

But some prices far exceed typical insurance payments for obesity treatments across the country, according to a medical billing data registry. Surgeons performed about 200,000 bariatric operations in 2020, according to the bariatric surgery society.

Wallace, the Brooklyn legal assistant, was billed $60,500 for her lap sleeve gastrectomy, though how much her insurance actually paid remains to be hashed out in court.

Michael Arrigo, a California medical billing expert at No World Borders, called the prices outrageous and unreasonable and, in fact, likely unconscionable.

I disagree that these are fair market charges, he said.

LaMasters, the bariatric society president, called the gastrectomy price billed to Wallace really expensive and a severe outlier. While charges vary by region, she quoted a typical price of around $22,000.

Garber said NYBG bills at usual and customary rates determined by Fair Health, a New York City-based repository of insurance claims data. Fair Health sets these rates based upon the acceptable price for our geographic location, he said.

But Rachel Kent, Fair Healths senior director of marketing, told KFF Health News that the group does not set rates, nor determine or take any position on what constitutes usual and customary rates. Instead, it reports the prices providers are charging in a given area.

Overall, Fair Health data shows huge price variations even in adjacent ZIP codes in the metro area. In Long Islands Roslyn Heights neighborhood, where NYBG is based, Fair Health lists the out-of-network price charged by providers in the area as $60,500, the figure Wallace was billed.

But in several other New York City-area ZIP codes the price charged for the gastrectomy procedure hovers around $20,000, according to the databank. The price in Manhattan is $17,500, for instance, according to Fair Health.

Nationwide, the average cost in 2021 for bariatric surgery done in a hospital was $32,868, according to a KFF analysis of health insurance claims.

Private Equity Arrives

Garber said in a court affidavit in May 2022 that he founded the bariatric practice with a singular focus: providing safe, effective care to patients suffering from obesity and its resulting complications.

Under his leadership, the practice has developed into New Yorks elite institution for obesity treatment, Garber said. He said the groups surgeons are highly sought after to train other bariatric surgeons throughout the country and are active in the development of new, cutting-edge bariatric surgery techniques.

In 2017, Garber and his partners agreed on a business plan to help spur growth and attract private equity investment, according to the affidavit.

They formed a separate company to handle the bariatric practices business side. Known as management services organizations, or MSOs, such companies provide a way for private equity investors to circumvent laws in some states that prohibit non-physicians from owning a stake in a medical practice.

In August 2019, the private equity firm Sentinel Capital Partners bought 65% of the MSO for $156.5 million, according to Garbers affidavit. The management company is now known as New You Bariatric Group. The private equity firm did not respond to requests for comment.

Garber, in a September 2021 American Society for Metabolic and Bariatric Surgery webinar viewable online, said the weight loss practice spends $6 million a year on media and marketing directly to patients and is on a roll. Nationally, bariatric surgery is growing 6% annually, he said. NYBG boasts two dozen offices in the tri-state area of New York, New Jersey, and Connecticut and is poised to expand into more states.

Since private equity, weve been growing at 30% to 40% year over year, Garber said.

Fred Schulte: fschulte@kff.org, @fredschulte Related Topics Health Care Costs Health Industry Insurance States New York Obesity Contact Us Submit a Story Tip

Entertainment

Urdd Eisteddfod: Why Strictly star Amy Dowden is supporting Welsh festival that is ‘like Britain’s Got Talent’

Published

16 mins ago

May 26, 2025

admin

Urdd Eisteddfod: Why Strictly star Amy Dowden is supporting Welsh festival that is 'like Britain's Got Talent'

Thousands of people are expected to attend Port Talbot this weekend as the town gears up to welcome an annual Welsh festival.

The Urdd Eisteddfod is a celebration of Welsh culture when children and young people up to the age of 25 take part in a variety of competitions.

There are 400 of them in total, including singing, reciting poetry and dancing.

The Urdd organisation itself was established more than a century ago in 1922, with the aim of giving children and young people in Wales the opportunity to learn and socialise in the Welsh language.

Its six-day Eisteddfod is held during May half-term and in a different part of Wales each year.

The Urdd Eisteddfod broke its own records last year, with more than 100,000 registrations to compete.

Margam Park is home to this year’s event – the first time since 2003 that it’s played host.

Among the main prizes up for grabs this year are the chair (awarded to the main poetry competition winner) and the crown (awarded to the main prose competition winner).

This year’s crown and chair have been made using some of the final pieces of steel produced at Port Talbot steelworks before the closure of the blast furnaces last year.

There are some new additions to this year’s Eisteddfod, including awards for singing, musical theatre and acting, named in honour of Sir Bryn Terfel, Callum Scott Howells and Matthew Rhys.

Another new award – the Amy Dowden award for dance – will also be awarded for the first time this week.

Speaking to Sky News, Strictly Come Dancing star Dowden said it was a “real honour” to be supporting the next generation of dancers.

“The arts and the industry is tough, and I just hope that [the young people] can see that I’ve managed to push myself through it,” she said.

“I’ve worked hard, I’ve had a few challenges along the way. Hopefully I can help inspire them as well.”

‘It’s like Britain’s Got Talent’

As a former competitor herself in what is one of Europe’s largest touring youth festivals, Dowden says she “couldn’t imagine [her] childhood without it”.

“I’ve loved Eisteddfods since I can remember. Every year at school I took part in everything, from the baking to the reciting poems, to the folk dancing, to the creative dancing,” she said.

“The Urdd Eisteddfod is literally like one big talent competition, it’s like Britain’s Got Talent.”

The winner of the Amy Dowden award will get one-to-one sessions with her as part of the prize, as well as masterclasses at the Royal Welsh College of Music and Drama.

They will have the opportunity to perform on an international stage and also win a cash prize.

“I know from my dance training and everything, each of those is so beneficial to getting yourself to that professional level,” Dowden added.

UK

Living beside the UK’s first drug consumption room

Published

16 mins ago

May 26, 2025

admin

Living beside the UK's first drug consumption room

It’s 8.34am on a Tuesday and Vanessa Paton is taking me on a tour of Glasgow’s east end, where she has lived for almost 50 years.

Half a mile away sits the newly opened taxpayer-funded facility, named The Thistle, where drug addicts can bring their heroin and cocaine, are handed clean needles and invited to inject under NHS medical supervision.

The concept, a UK first, is controversial and costs £2.3m a year.

Authorities believe it provides a safer, cleaner area for users to do their business, away from the dirty, HIV-ridden back alleys of Glasgow city centre.

It opened in January, and around 250 people have used it so far.

But there is a growing feeling among some that a by-product of this bold project is the alleged “war zone” being created in the community around the new building.

Former council worker Ms Paton is one of an ad-hoc group of furious locals who pick up needles as part of desperate efforts to clear their streets.

She says: “It is getting worse. The new room has appeared, and the problems have escalated with it. It’s a no-go war zone every day and night.

“The area’s becoming a toilet. That is the harsh reality of it.”

‘It is disgusting’

Sky News spends the morning being shown areas where it is claimed the issues are getting out of control.

Ms Paton pulls a bloodied, faeces-covered hospital gown out of a bush as we walk along a path behind a row of houses.

We turn the corner to a street where children play and are greeted with syringes filled with blood at our feet, discarded needle packaging and dirty underwear.

Local resident Angela Scott says: “It’s become a lot worse. It’s heightened. I’m scared that if I am picking up my dog dirt am I going to prick a needle.

“Am I going to end up with an infection that a lot of drug addicts tend to have because they are sharing needles? I don’t want to pick up something infectious.”

Adverts installed in known drug dens

Officials have installed a new needle bin in one hotspot in recent days, with posters erected advertising the nearby consumption room.

Ms Paton alleges safety steps are being taken at a nearby nursery.

“There is a nursery that actually uses a metal detector in the morning to scan the sandpits before the children go out because of the concern of the needles being in it,” she claims.

This area is known as Calton and has had its troubles with drug taking and crime for many years.

Ms Paton takes us to a tucked-away, overgrown area opposite social housing and a few metres from where a new school is being built. It is a makeshift drug den.

There are hundreds of freshly used needles. It is like a minefield.

One needle is stabbed into a large tree, there is even a wooden seat which is covered in drug-taking equipment.

Once again, there is a laminated A4 piece of paper pointing users in the direction of The Thistle.

Ms Paton says: “We picked up 50 needles in one minute last week. If we were to pick up every needle that is here today, we’d be talking hundreds.

“We are struggling to find somewhere safe to stand. There are needles between my legs, you’ve got needles behind your head.

“It’s totally soul-destroying. Nobody living here expected it to be this bad.”

Officials deny it is a new problem

Glasgow City Council told Sky News there had not been an increase in reports despite the community alleging the opposite.

Councillor Allan Casey, who is responsible for drug policy in the city, said: “This has been a long-standing issue and that is one of the main reasons why The Thistle has been placed where it is because there has been decades-long discarded needles in public places.

Responding to claims of increasing problems around the new facility, Mr Casey said: “Those reports don’t back that up.

“The council has not seen a rise in reports of injecting equipment and there has not been an increase in crime reports.”

Scotland is ravaged by drugs. The country has the worst drug death rate in Europe.

Scotland’s first minister John Swinney told Sky News the new drug room required time to “see the impact”.

He said: “The Thistle is a safe consumption facility which is designed to encourage people to come off the use of drugs – that’s its purpose. We’ve got to give that venture time to see the impact.

“We need to engage with the local community… and address any concerns.”

It is understood police have logged no calls about the facility since it opened in January, despite some residents suggesting they have contacted officers with concerns.

Inspector Max Shaw from Police Scotland said: “We are aware of long-standing issues in the area and continue to work closely in partnership to address these concerns.”

Sports

Edmonton takes control over Stars: Game 3 grades, takeaways

Published

3 hours ago

May 26, 2025

admin

Edmonton takes control over Stars: Game 3 grades, takeaways

Multiple Contributors

May 25, 2025, 06:35 PM ET

While fans in Edmonton and Dallas are always singing about how they have friends in low places, only one of them has the high ground in the Western Conference finals. And that’s the Oilers after their 6-1 win Sunday in Game 3 to take a 2-1 series lead.

With the series tied heading into Sunday, the objective for Game 3 was to gain a firm grasp of the conference finals, and the Oilers did just that by having five players with multipoint performances. As for the Stars, losing Game 3 left them trailing a series for the second time this postseason, with the only other such occurrence coming after Game 1 against the Colorado Avalanche in the first round.

Now that the Oilers are in control of the series, what does it mean for them going forward? What must the Stars do differently ahead of Game 4 for them to return home tied rather than a game away from elimination? Ryan S. Clark and Greg Wyshynski examine those questions while delving into what lies ahead for two teams that not only faced each other in the conference finals last season but between them have been involved in every conference final since 2020.

Edmonton Oilers
Grade: A

Much could change between now and whenever the playoffs end. But for now, the argument could be made that this was the most important playoff game the Oilers have had this postseason.

The Oilers have had numerous strong performances, such as Game 3 against the Los Angeles Kings in the first round or their final two games against the Vegas Golden Knights in the conference semifinals. But what made the Oilers’ performance in Game 3 against Dallas arguably their most important was that they found a balance between being difficult in the defensive zone while not relying on a shutout to accomplish that objective.

The Stars finished with 37 shots, 13 high-danger chances in 5-on-5 play and scored only once. Connor McDavid has repeatedly stressed that the Oilers can play defense, and that has been made clear over their past five games. But Sunday proved they didn’t need Stuart Skinner or their defensive structure to blank an opponent to win. — Ryan S. Clark

Dallas Stars
Grade: C+

The final score doesn’t reflect the majority of this game, which Dallas coach Pete DeBoer can mine for positives among the many (many) negatives and some mitigating circumstances. Having Roope Hintz warm up but not be able to go because of the foot injury he suffered from a Darnell Nurse slash in Game 2? That’s deflating. Having the on-ice officials miss a delay of game call on Brett Kulak in the first period only to have Evan Bouchard open the scoring 10 seconds later? Also deflating.

So it’s to the Stars’ credit that they got to their game at 5-on-5 in Game 3 better than they have in any game of the series, at least before Edmonton ran up the score in the third. The results weren’t there and a loss is a loss — and a loss by this margin is difficult to stomach — but their second period and the performances from some of their slumbering depth players give the Stars at least a glimmer.

However, there’s no question Edmonton has this thing in well in-hand and the Stars have to find a way to solve Skinner, which is not something I thought I’d be writing at this stage of the postseason. — Greg Wyshynski

Three Stars of Game 3

Two goals and an assist for his seventh career multigoal playoff game. Hyman’s second goal was the Oilers’ fourth off the rush, the most in one game by any team this postseason. Hyman also was plus-5 Sunday.

Bouchard scored his sixth goal of the postseason and these two were on the ice for the first two Edmonton goals. At 5-on-5 this postseason, the Oilers are outscoring their opponents 7-1, and 5-0 in this series, when Bouchard and Kulak are on the ice.

Connor McDavid restores Oilers’ 2-goal lead

Connor McDavid finds the back of the net to restore the Oilers’ two-goal lead vs. the Stars.

3. Connor McDavid
C, Oilers

For all the talk about the lack of goals from the best hockey player in the world (which was odd because he had 20 points in 13 games and was a plus-7 entering Game 3 despite having only three goals), McDavid punched out a pair of tucks for his sixth career multigoal playoff game. Also, seeing McDavid with the puck barreling toward the net on a 3-on-1 is nightmare fuel for opponents. — Arda Öcal

Players to watch in Game 4

Zach Hyman
LW, Oilers

To go from 16 goals last postseason to just three goals entering Game 3 of the conference finals is one way to assess Hyman. Another is to realize that he’s been the most physical player on a team that is among the tallest and heaviest in the NHL.

Hyman came into Game 3 leading the NHL with 99 hits. He remained physical Sunday by leading the way with six hits in a game that saw the Oilers continue their punishing style with 47. But to then see Hyman score two goals and finish with three points in addition to that physicality? It once again adds to the narrative that the Oilers might not only have more dimensions than last year’s team, they could be better than the team that finished Stanley Cup runner-up in 2024. — Clark

Zach Hyman’s 2nd goal puts Oilers up 4

Zach Hyman taps home his second goal of the game to put the Oilers up 5-1 vs. the Stars.

This is the first two-game losing streak for the Dallas goaltender in the playoffs. A lot of what happened in Game 3 wasn’t necessarily on him — a Connor McDavid beauty and a Zach Hyman breakaway were among the Edmonton tallies — but outside of the third period of Game 1, he’s not been a difference-maker in this series. Oettinger came into the game leading the playoffs with 5.58 goals saved above expected, according to Stathletes. The Stars have been able to depend on him as a slump-breaker. But this is his third game with a save percentage south of .900 in the series. As the Stars try to build on some positives from this game, they need Otter to provide the foundation for it — and in the process, silence those “U.S. backup!” chants from the Oilers fans. — Wyshynski

Big questions for Game 4

Are the Oilers about to do to the Stars what they did to the Golden Knights?

Simply put, the Oilers are where hope goes to die. Teams in a championship window that have yet to win a title are always being judged on their evolution. What the Oilers did to the Stars a year ago in the conference finals by winning the last three games showed that they could close out a series after trailing. This postseason Edmonton has shown a calculated and methodical coldness when it comes to putting away opponents.

The Golden Knights won Game 3 on a last-second goal to create the belief they may have found an opening. They didn’t score again for the rest of the playoffs after being in the top five of goals per game throughout the regular season. Breaking out for six goals to open the series seemed to be a sign the Stars may have found an opening. Since then? They’ve scored only once in the last six periods while facing questions about what’s happened to another team that went from being in the top five in goals per game in the regular season. — Clark

Can Dallas make Edmonton uncomfortable at all?

Our colleague Mark Messier made this point between periods of Game 3: The Stars have yet to do anything to get McDavid or Leon Draisaitl off their games. That extends to the rest of the Oilers. Outside of an anomalous run of three power-play goals in the third period of Game 1, there have been precious few instances of the Stars carrying play for long stretches or putting a scare into Edmonton at 5-on-5.

They had that for a bit in Game 3 with a dominant second period: plus-14 in shot attempts, plus-11 in scoring chances and a 10-1 advantage in high-danger shot attempts. But they were digging out of a 2-0 hole, only managed to get one goal of their own on the board and then McDavid stuck a dagger in them with 19 seconds left in the second.

The Stars need a lead. They need zone time. They need to get their rush game going: Skinner had a .897 save percentage on shots off the rush entering the game. Edmonton is playing with a champion’s confidence. Dallas has to find a way to inject a little doubt into its opponent or this series is going to end quickly. — Wyshynski