Illegal Payor Practices
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The current climate of the healthcare industry is threatened by Provider discount abuse practices that could make Traditional Health Plans, CDHPs, and Workers' Compensation companies responsible for potentially billions of dollars worth of illegal discounts given on Member claims.
Although prenegotiated discounted rates between Providers and Payors is an integral part of the industry, Provider discount abuse practices like Silent PPOs and Cherry Picking are two unethical practices threatening the integrity of the healthcare landscape.
Recently, the Provider community has begun to react against these illegal practices, which result in costly litigation and class-action lawsuits. Access downloadable documents detailing recent legal cases and court rulings.