The Arizona Supreme Court will not review a petition from two Arizona ambulatory surgery centers which claim the state's leading workers' compensation insurer broke the law by using an outside vendor to determine what the ASCs should receive for workers' compensation payment, according to an Insurance Journal report.
The ruling means the decision by the Arizona Court of Appeals to affirm a county superior court decision that no law was broken is now the established standard for ASCs, and likely all providers.
The ASC Association had filed an amicus brief with the Arizona Supreme Court in support of the two member facilities contesting the out-of-network rates paid by the workers' compensation carrier. The brief sought to convince the Arizona Supreme Court to review the appellate court decision.
The Arizona ASCs, Canyon Ambulatory Surgery Center in Phoenix and El Dorado Surgery Center (now known as Tucson Surgery Center), had sued in hopes of receiving 100 percent of billed charges from SCF Arizona, the workers' compensation carrier, after Qmedtrix, the outside bill reviewer, recommended less, according to the report.
The appeal court upheld a 2008 county superior court decision that the practice by SCF Arizona to use an outside vendor to receive recommendations for what to pay when reimbursement is not previously determined by contract or fee schedule is an acceptable practice and the amount recommended by Qmedtrix and paid to the ASCs was reasonable.
The ASCs received $3.59 million and were seeking an additional $4.69 million from SCF Arizona.
Read the Insurance Journal report about Arizona workers' compensation.
Read more about workers' compensation:
- States Propose Legislation to Alter, Scrap Workers' Comp
- Spine Surgeons and Workers' Compensation: 5 Things to Know
- California Ambulatory Surgery Association Fights Proposed Workers' Comp Reductions