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?”

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