Our position on discounts recommended and taken by repricing companies, such as Fairpay Solutions, Inc., is that they are unlawful. Insurance companies and employers are responsible for the hospitals’ charges reflected on their Pricemasters filed with the Office of Healthcare Access (OHCA). We work to recover payments in full for these services.

Both before and after the adoption of the hospital fee schedule, effective in April 2015, insurance carriers and employers, with support of repricing vendors and PPOs, have consistently taken substantial unlawful discounts on workers’ compensation bills that deprive Connecticut hospitals of millions of dollars in revenue. We handled the landmark Connecticut Supreme Court case, Caraballo v. Electric Boat §315 Conn. 704 (2015), which established that hospitals must be paid their Pricemaster charges absent a negotiated agreement. We have successfully resolved thousands of claims for our hospital clients involving pre-fee schedule cases. We continue to challenge unlawful discounts taken by payers under the new fee schedule.

Attorneys in this Practice Area:

Robert D. Tobin

Robert D. Tobin

Commercial Litigation, Gaming Law, Real Estate Transactions, Medicaid Revenue Recovery, Medicaid Audit & Compliance and Workers’ Compensation Revenue Recovery

Jerry O'Malley

F. Jerome O’Malley

Personal Injury & Wrongful Death, Criminal Defense, Alternative Dispute Resolution, Liquor Licensing, Gaming Law and Medicaid Audit & Compliance

Thomas J. Riley

Thomas J. Riley

Employment Law, Commercial Litigation, Medicaid Revenue Recovery, Workers’ Compensation Revenue Recovery and Alternative Dispute Resolution

Emily R. Casey

Emily R. Casey

Workers’ Compensation Revenue Recovery, Medicaid Revenue Recovery, Intellectual Property and Cultural Property