Two anesthesia medical groups have lost their appeal against the Medi-Cal managed health care insurance agency Inland Empire Health Plan.
Upland Anesthesia Medical Group and Allied Anesthesia Medical Group, of Orange, sued IEHP March 23, 2018, alleging the company was underpaying them by paying at the Medi-Cal rate instead of their customary rate, losing them $11.7 million from 10,000 services between 2014 and 2018.
“For years, Defendant has knowingly and willfully shirked its legal obligation to pay Plaintiffs reasonable and customary value for non-emergency anesthesia services Plaintiffs provided to Defendant’s HMO enrolled,” their 468-page complaint begins.
The published appellate ruling established that the IEHP was correct, and should, as
