subject: DePuy's Reimbursement Plan to Avoid Lawsuits over Its Defective Hip Implants Will Cost Physicians, Hospitals, Insurers, Medicare, and Victims [print this page] DePuy's Reimbursement Plan to Avoid Lawsuits over Its Defective Hip Implants Will Cost Physicians, Hospitals, Insurers, Medicare, and Victims
Those anticipating a reimbursement from DePuy Orthopaedics for revision surgeries to remove their defective hip implants should look more carefully at the company's offer before filing DePuy recall lawsuits. One would think that the reimbursement related to the recall would be unconditional: those with faulty implants would have them removed by their doctors, and the doctors would then send the bill to DePuy for reimbursement. This is not what DePuy has in mind. Instead, the process will be much more complicated.
DePuy is requesting the doctors submit their bills to insurers or to Medicare, and after they are paid, the insurers will then request reimbursement from DePuy. As a result of adding third parties to the reimbursement process, insurers will necessarily reduce their coverage to doctors for revision surgeries, leaving patients to pay any remainder. Meanwhile, the reimbursement process will cost insurers more in administrative costs, so victims will have to pay even more. Rochelle Rottenstein of the Rottenstein Law Group disapproves of DePuy's plan:
"DePuy does not intend to pay doctors or other medical service providers directly. Rather, DePuy intends to pay back insurers, after the insurers first pay the doctors and hospitals. This means that the medical professionals will be forced to accept the reduced insurance rates for the services they provide to the victims. Although doctors and hospitals agree to accept lower rates to participate in any given coverage plan, in these circumstances it seems plainly unfair to make them take reduced fees."
From here, DePuy's plan to avoid lawsuits burdens hip implant victims even more. To qualify for a reimbursement, DePuy would require recipients to prove that they deserve a reimbursement. DePuy will consider paying the costs if recipients give DePuy their x-rays, medical records, and the removed hip implant itself. Even if recipients provide all the above materials, DePuy still reserves the right to determine whether to reimburse recipients. Because DePuy has set no standards for reimbursing anyone, it may elect to reimburse no one. For a company trying to avoid lawsuits, DePuy's opaque reimbursement process does not help hip implant recipients much less their doctors and insurers.
If DePuy's hip implant recall affects you, don't wait for DePuy to decide whether your insurance company deserves to be reimbursed for its own faulty implant. Keep your medical records and faulty hip implant, and demand compensation from DePuy. The Rottenstein Law Group is ready to help.
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