Subject: Califoria Legal Action
Hey Guys, I wondered if you guys ( bloggers supreme ) had seen this case out of California ? Started as an action by an audit firm against Sutter Health and then the California Department jumped in. The interesting detail to me is how PHCS / MultiPlan is being treated as an “ accomplice “ due to the onerous terms of the PPO agreement ( i.e. no audit , no review ).
My opinion is that this case could be huge if it gets legs and other Departments across the country pick up on the logic. While this case is specifically applied to the anesthesia sleight of hand , could the same rationale not be applied to other areas ? How much abusive billing is covered over by the handcuffs placed on plans via PPO contract terms ? Arguably, the entire chargemaster process is driven by the incentive of “ percentage off “. Bill more get more.
CA v Multiplan (FOR A QUICK REVIEW, READ PAGES 12-18)