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Friday, February 23, 2024 | Back issues
Courthouse News Service Courthouse News Service

Class Fights PPO Discount on Workers Comp

PORTLAND, Ore. (CN) - Travelers Insurance pays less for treating workers comp patients than is required by state law, a physical therapy office claims in a federal class action.

Lincoln City Physical Therapy claims Travelers paid it rates that were "discounted pursuant to a private, unregulated contract with so-called 'Preferred Provider Organizations' (or 'PPOs'). Plaintiff and members of the class seek to recover all of the discounted amounts that defendants did not pay to plaintiff and members of the class, based on defendants' application of a private contract between defendants and any PPO, which resulted in a lower payment amount than was required under Oregon workers' compensation law."

Lincoln City says Travelers contracts with PPOs that allow it to apply a "PPO discount" to providers in workers' compensation cases.

However, "Throughout the relevant time period, applicable Oregon workers' compensation statutes and rules did not allow workers' compensation insurers, like defendants, to apply any PPO contract discounts to the payment of workers' compensation medical fees," the complaint states.

Lincoln City claims that "hundreds of medical providers statewide who provide services to injured workers' under the Oregon state workers' compensation systems have been damaged by defendants' illegal PPO discounting."

Lincoln City is represented by Steve Larson and Joshua Ross with Stoll Stoll Berne Lokting & Shlachter.

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