Paying for patients: How some providers are distorting health coverage

– Daily Journal

Healthcare litigation leader Gregory Pimstone authored an article for Daily Journal discussing how some out-of-network substance abuse treatment facilities have challenged the PPO plan structure of requiring insureds to assume a higher share of cost for out-of-network services. In the article, Pimstone analyzes these efforts, addressing the question, “what if out-of-network providers sought to throw a wrench into the PPO structure by giving patients financial incentives to treat with them, making it more financially advantageous for the PPO member to go out of the insurer's network?”



pursuant to New York DR 2-101(f)

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