Today’s edition of WorkCompRecap has one story I am particularly excited about.
The lead story below describes a long running court case involving Arizona’s largest workers’ compensation insurer and a couple of ambulatory surgery centers. The litigation started back in 2003 when the ambulatory surgery centers filed suit seeking 100% of their billed charges, following reductions by the payer to “fair and reasonable” payment amounts. These payment amounts were recommended by a 3rd party vendor, a specialist in the “fair and reasonable” repricing and review business. The surgery centers have until November 26 to appeal to the Arizona Supreme Court.
Why is this a potentially huge victory for payers?
Because a payer finally drew a line in the sand and said “enough is enough” to the cost shifting and rapidly escalating billed charges in workers’ compensation, specifically in the hospital and surgical facility segment. AND THEY WON (for now at least)!
For that, they deserve a lot of credit, and I hope it inspires others to do the same. This isn’t just a problem in Arizona, it is a problem nationally, and it is time to develop creative solutions to address it.
Read the rest of the article at WorkCompWire to learn more.
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Patrick J. Sullivan
Managing Editor
WorkCompWire
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