Reference Based Pricing Under Fire

A recent Supreme Court case in Texas involving a hospital lien held that contract payments involving Medicare multipliers and other accepted payments could be evidence of reasonable, fair market value.

Cases often will start with a discovery battle that Bennett says the employer or patient gain significant leverage if the court rules that a hospital has to disclose contractual information and chargemaster details.

Self-Insurer 2018-12 (sipconline.net)

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