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Stericycle contracts: Read the fine print

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Stericycle contracts: Read the fine print

Dentists question business practices

June 20, 2016

By Kelly Soderlund

Hazardous waste pickup: A Stericycle truck parks in Chicago, not far from the company’s headquarters in Lake Forest, Illinois. Dentists have complained to the American Dental Association that Stericycle did not specifically outline escalating fees in their contracts.

A 250 percent increase in price over seven years would probably prompt any business owner to do some investigating.

It certainly gave Dr. Carolyn Romzick pause and led her to do some pretty extensive research into Stericycle, a Lake Forest, Illinois-based medical waste disposal company. She found she wasn’t alone in feeling aggravated and deceived at how the company was doing business.

Dr. Romzick is among a number of dentists from across the country who have contacted the ADA to report escalating fees that were not explicitly stated in their original contracts and contracts that automatically renew with only a small window to cancel before it re-ups for several more years.

Dr. Romzick

For Dr. Romzick, who practices in Farmington Hills, Michigan, it started earlier this year when she received a flier offering pickup for medical waste at a price that intrigued her enough to study her invoices for what she was currently paying.

The new company advertised its price at $60 per pickup, which is typically quarterly in the medical waste business. Dr. Romzick had signed a contract with Stericycle in 2009, so she was curious how this new rate would compare.

In 2009, Dr. Romzick said she was paying Stericycle a monthly charge of $105 — $315 each quarter — to pick up one 28-gallon container that typically wasn’t full. By the first quarter of 2016, Dr. Romzick said her quarterly bill had risen to $1,100: a nearly 250 percent increase from when she originally signed a contract.

“The original contract stated there may be increases related to rising fuel costs or increased fees Stericycle incurred for disposal that they could pass on to the customer,” Dr. Romzick said.

“I figured those kinds of things happen. That’s reasonable. But I think we can all agree that fuel prices have not been consistent since 2009, but somehow my invoices from Stericycle have increased consistently.”

Dr. Romzick said she didn’t keep up with the increasing charges from Stericycle because the amount was debited automatically along with numerous other charges that came through the dental office’s account.

When she turned to the internet to find out more about Stericycle, Dr. Romzick said she was surprised to learn the company was the subject of a number of lawsuits. In October 2015, the Illinois attorney general’s office announced a $26.75 million settlement with Stericycle for allegedly overcharging government entities in several states by millions of dollars, resolving the company’s alleged violations of the U.S. and State False Claims Acts.

The lawsuit was brought by a whistleblower that was a former Stericycle employee on behalf of the federal government and later 14 states and the District of Columbia, according to a statement from Illinois Attorney General Lisa Madigan.

The lawsuit alleged that since 2003, Stericycle implemented a plan to charge automatic price increases without giving any notice to its government customers in violation of state and federal false claims laws, according to the statement from the Illinois attorney general’s office.

Stericycle’s automated price increases were purportedly fuel and energy surcharges, but they did not reflect actual increases in fuel and energy costs.

According to the lawsuit, these fraudulent price increases — amounting to 18 percent every nine months — violated prices set in the company’s contracts.

Illinois, California, Delaware, the District of Columbia, Florida, Indiana, Massachusetts, Nevada, New Jersey, North Carolina, Rhode Island, Tennessee, Virginia and the federal government will receive portions of the settlement.

In a separate lawsuit, Hagens Berman, a law firm based in Seattle, filed a class action lawsuit in 2013 against Stericycle alleging that the company misled its customers regarding pricing. In January, the firm filed a motion to certify the class of plaintiffs.

“The first rule: a deal is a deal. Stericycle entered into fixed-price contracts and it was obligated to honor those prices,” according to the lawsuit, which can be viewed at “The second rule: tell the truth. Stericycle was obligated to give its customers accurate and complete information about its service contracts and the prices it charged.”

Stericycle did not respond to requests for comment.

Dr. Eugene Kim, of Buena Park, California, is one who doesn’t believe Stericycle held up its end of the deal. He said that he signed a contract with Stericycle in May 2014 that included a three-year term under the assumption he was locking in a rate of $180 for pickup at a minimum of twice per year.

“That’s the purpose of signing a long-term contract: to avoid a future price increase,” Dr. Kim said.

According to Dr. Kim, the contract stated that Stericycle may periodically raise the fee to accommodate a rise in operational cost. Over the next two years, Dr. Kim received quarterly bills for $220, $279, and ultimately $398. The lowest bill he received was for $108 — after Stericycle came by and his office was closed so they did not haul away any waste.

“When I signed the contract, I thought each bill would be $180,” Dr. Kim said. “My staff called Stericycle and they said they raise fees by 18 percent every nine to 12 months.”

In order to be released from his contract, a Stericycle employee told Dr. Kim he would have to pay out the remainder of his contract. His math showed that amount to be $400.

When Stericycle did the math, they told Dr. Kim he would owe $1,777 to be released from the contract.

“I don’t know how this company has been allowed to go on for so many years,” Dr. Kim said.

Dr. Vincent F. Fuschino, of Mechanicville, New York, has been a Stericycle client for nearly 20 years and didn’t realize he had a problem with the company until his son, Dr. Vincent P. Fuschino joined his practice and noticed the bills seemed high.

The father and son ultimately figured out that their bills were increasing by 17 percent every six months — something that was not outlined in their original contract with Stericycle.

Dr. Vincent F. Fuschino said he started out paying Stericycle around $80 a month, which increased to $1,853 a month by the end of this relationship with the company.

He said he called Stericycle to end his business relationship with them, was told he could not terminate his contract and the company threatened to take legal action against him.

Like other dentists who wanted to get out of their contracts, Stericycle told Dr. Fuschino he would have to pay out the contract. He refused and Stericycle ultimately agreed to let him out of his contract without charging him a fee.

The same thing happened to Dr. Nathan Roth in San Francisco. Dr. Roth said he was on a year-to-year contract with Stericycle, noticed his fees were increasing and he wanted to hire another vendor to dispose of his practice’s medical waste.

He called Stericycle to tell them he did not want to renew his contract and was told he electronically signed a longer-term contract to which he was bound. Dr. Roth said he never signed anything but was told if he wanted to cancel the service, he would have to pay hundreds of dollars.

Dr. Roth filed a complaint against Stericycle with the Better Business Bureau, he said. Stericycle ultimately dropped the issue and told Roth they “would do a professional courtesy” by letting him out of the contract he said he never signed.

“I would caution ADA members that before they sign anything with Stericycle to read the fine print,” Dr. Roth said. “It’s very underhanded and suspicious in the way they practice their business.”

The ADA offers guidance on the Center for Professional Success on how to navigate contracts containing auto renewal provisions

The Michigan Dental Association has been cautioning its members with the same message: be careful when it comes to signing contracts.

“Some members are surprised to hear that they can be held to contracts that their staff signed. That’s why it is so important not to delegate this authority to any staff member and to educate your staff that you are the only one who should agree to contracts on behalf of the practice,” said Karen Burgess, executive director of the Michigan Dental Association, which has also received multiple complaints from members about Stericycle.

“As with any contract, it is important to read, understand and seek legal advice if you have any uncertainties, before you sign it. Don’t rely on any verbal explanations that you might hear from a salesperson. And even if you think the contract looks good, be sure to do your due diligence and consider other options.”

August 5, 2016

Many dental practices are disposing of their medical waste incorrectly. They are overspending by improperly classifying medical waste and adding items that could be going into the solid waste stream. Is your practice disposing of medical waste properly?

Medical waste disposal
often costs five to eight times as much as solid waste disposal. When health-care professionals select a company to manage their medical waste, they want a reliable service that will address their unique needs. While many services can meet those expectations, their prices can vary dramatically.

If you feel like you’re overpaying for your medical and biohazard waste disposal, it’s important to familiarize yourself with the factors that affect the cost. You can perform a quick audit of your current medical waste needs and assess whether or not your current provider is meeting your requirements.

You’ll want to become familiar with your state’s regulations and to stay up to date with your OSHA compliance training. Proper training will ensure safe and compliant disposal practices. Also, each state has different rules and regulations for handling, labeling, time of storage, weight, recordkeeping, and container management of medical waste.

Many dental practices find themselves overspending by improperly classifying medical waste and adding items that could be going into the solid waste stream. Properly segregating your waste can help your practice cut down on expenditures, but many health-care providers place items that could be going into a regular trash bin in the red biohazard bags.

A common misconception is that any item that comes in contact with bodily fluids or infectious materials is considered medical waste or biohazardous waste. By OSHA definitions, items with trace levels of contamination can be placed in municipal solid waste. Bandages or gauze with small amounts of blood can be disposed of in regular trash cans.

Once you’re sure that everyone in your practice is properly classifying your medical waste, you can figure out how much medical waste you’re actually generating on a typical cycle. From there you can decide how often you need to schedule your pickups.

The frequency of scheduled pickups will factor into your price. Take a look at your medical waste bags before your scheduled pickup. If they’re consistently half or a quarter full, you might want to think about switching frequency and saving a trip.

In some circumstances, a pickup plan may not make sense. If you’re a small-scale generator, you can look into mail-back programs. This means that a regulated medical waste container will be shipped to your practice, and when it’s full you simply return the container via mail. This is also a great option if you’re in a remote location where transportation fees are higher.

Once you’ve assessed the volume of waste you’re generating and the frequency with which it’s picked up, look at the different services being offered and see if you can bundle them together to get more for your dollar. For instance, some practices might be paying separately for their sharps disposal, biohazard red bag disposal, and compliance training. Talk with your hauler and see if there’s any way to bundle these services.

Finally, you’ll want to make sure that you’re properly covered in the event that something happens during the transport of your waste. Learn about the insurance coverage of the disposal service. This could potentially save you thousands in the long-run. Accidents do happen, and you want a service that offers the peace of mind that you’ll be protected should something occur.

So if you’re overpaying for your medical waste disposal service, do a quick audit of your needs and make sure your service takes into account factors such as volume and frequency. It also doesn’t hurt to shop around and look for a more flexible service. You shouldn’t have to stress over the cost of a required service.