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