Suing to be paid for prior authorizations


Hopefully this will set a precedent:

Gary Gibson, FACP, sued MEDCO Health Solutions of Columbus North, Ltd., in Trumbull County Court to collect on the time he spent filling out two or three prescription inquiries a week, each taking between six and 10 minutes to complete. He told MEDCO in December 2005 that he would bill $150 an hour to fill them out, and when MEDCO said they would not pay, he sued in 2006.

The courts decided March 6 of this year that MEDCO’s prescription inquiries were designed to examine whether the prescriptions were the most economical for MEDCO, and since they were solely for MEDCO’s benefit, Dr. Gibson could collect payment for his time.

Here is the court’s decision.


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