MPN

10 Ways to Fix CA Workers' Comp

Today, the California Division of Workers’ Compensation (DWC) will host a virtual public meeting “to hear ideas to improve the efficiency and quality of care provided to inju...

Zenith Boots Doctor From MPN per Anthem PPO (Part II)

Our tale of one doctor’s struggle with the Anthem Blue Cross Preferred Provider Organization (PPO) took a disturbing — if predictable — turn.Despite a doctor’s request...

The Hartford Ignores TWO California Laws

By insisting The Hartford owed no payment for authorized treatment provided outside the Medical Provider Network (MPN), The Hartford pooh-poohed a clear-cut Cal...

Zurich - An Example of California's MPN Shell Game

Where opacity and obfuscation reign, injustice thrives. There may be no better example of this than California’s Medical Provider Network (MPN) system. T...

MPNs: The Jekyll and Hyde of Workers' Comp

We’ve argued that MPNs are mostly a drag on the workers’ compensation system. But as some employers demonstrate, they don’t have to be.When employers use MPNs to maint...

Anthem/SCIF: MPN Kickback Scheme?

Healthcare software firm CareCloud recently agreed to a $3.8 million settlement, in part to resolve allegations that it traded unlawful payments for referrals, in violation o...

California MPNs: Camouflage for Discounts and Denials

Medical Provider Networks (MPNs) are under fire — as they should be.Far too often, Calforina claims administrators (aka ‘payers’) use MPNs — and providers’ unfamiliari...

Payola? SCIF / Anthem Coordinate Provider MPN Shakedown

State Compensation Insurance Fund (SCIF) and Anthem Blue Cross (Anthem) have hacked the Medical Provider Network (MPN) system to apparently shake down providers. A recent ema...

Mob Rule: SCIF/Anthem Hold Patient(s) Hostage

On paper, Medical Provider Networks (MPNs) are a simple workers’ comp quality/cost-control measure. Employers designate an MPN, and injured workers choose from among the MPN ...

Provider Warning: Prime Health Services (Part II)

Prime Health Services (PHS) provided an unbelievable example of just how far PHS will go to secure unearned PPO discounts for their “clients”, including producing a missing s...

Provider Warning: Prime Health Services (Part I)

Recently, a provider made the unfortunate mistake of signing a Prime Health Services (PHS) Preferred Provider Agreement contract, commonly known as a PPO agreement. While not...

Conditional Authorization: How MPNs Cheat Workers’ Comp Providers

Medical Provider Networks (MPNs) are a drag on California workers’ compensation. Nominally designed to help employers control costs, MPNs rarely achieve more than throwing up...