Across the nation, providers struggle to treat injured workers without financially damaging their practices. The problem is especially ugly in California, where extreme reimbursement discounting is rampant.

Our NEW weekly “Diabolical Discounts” feature brings you the most atrocious examples.

If you thought the live-action Snow White was torture, wait until you see what Disney did to a California doctor who treated one of their injured workers.

Self-insured employer Disneyland Resort used a MultiPlan Preferred Provider Organization (PPO) contract to gut the doctor’s reimbursement—slashing 56% off the Official Medical Fee Schedule (OMFS) rate. The doctor got less than half of what California deems reasonable for workers’ comp care, and only about two-thirds of the Medicare rate for the same service.

This isn’t an isolated case.

PPO discounting schemes like this are widespread—and may help explain why injured workers often struggle to find doctors willing to treat them. The problem isn’t provider consolidation. It’s the financial disincentive created by aggressive discount contracts.

Take a look at the Disney Explanation of Review (EOR) below and see how the “happiest place on Earth” turns into a nightmare for medical providers.

Disney Slashes Workers’ Comp Reimbursement to 66% of Medicare—Thanks to MultiPlan

Disneyland may be famous for its stomach-dropping rides, but for this doctor, the most gut-wrenching experience came in the form of an EOR.

For billing code 99214, the Official Medical Fee Schedule (OMFS) sets the reimbursement at $205.41. But instead of paying this amount, Disney—via a MultiPlan PPO contract—slashed the payment by $115.21, reimbursing the doctor just $90.21.

That’s right: neither Disney nor MultiPlan rendered a single second of medical care to the injured worker, yet they siphoned off more than half of the compensation owed to the treating physician.

The doctor who delivered the care received just 44% of the OMFS rate—an amount that translates to 66% of what Medicare would have paid. In fact, the MultiPlan discount taken exceeded the amount Disney paid the doctor.

This is the power of PPO discounting. Payers and discount contracting entities strip away provider reimbursement without ever touching the patient.

PPO Discounts Force Doctors To Tap Out of Workers’ Comp

Providers often sign PPO contracts to gain membership in Medical Provider Networks (MPNs) and secure eligibility to treat injured workers. But in this case, the California Division of Workers’ Compensation lists Disney’s MPN as Harbor Health Systems—not MultiPlan.

Most physicians don’t realize that these PPO agreements can impose deep reimbursement cuts without delivering the benefits promised. Once providers discover the financial damage, many opt out of workers’ comp entirely rather than battle opaque PPO pricing schemes.

We’ve seen claims administrators impose arbitrary discounts exceeding the PPO contract terms. Factor in the widespread practice of discount transfers between entities, and a single PPO signature can unravel the financial viability of workers’ comp for an entire practice.

The result is that Disney saves a few dollars, MultiPlan takes its cut, and California employers are left scrambling to find physicians willing to treat their injured workers.

Disney tells children that dreams come true when you wish upon a star. But for medical providers, the dream of fair reimbursement through PPOs like MultiPlan is just another fairy tale—with a far grimmer ending.

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