IS THIS A 4906G VIOLATION?http://www.crossroadstoday.com/story/34 ... ll-medical
Above is the LINK to the article/law suit, and below is some language from the pleading
OCM has developed an opaque, unfair and illegal scheme whereby OCM maximizes the compensation it receives from its payor clients by referring injured workers to those of its contracted health care professionals who accede to the deepest discount. This system is nothing like a traditional “Preferred Provider Organization” (“PPO”) where the PPO contracts with health care providers payors let their beneficiaries choose to receive services from any of the health care providers who contract with the PPO, and then the payors pay the claims submitted by those contracted providers. OCM does not offer health care professionals the opportunity to be listed in a directory. Rather, OCM solicits (or extorts) deep discounts of a specified amount from its contracted health care professionals as an inducement for it to send them a specified number of additional referrals. Similarly, unlike traditional PPO arrangements, injured workers are not free to select a care provider from among the contracted health care professionals. Rather, OCM assigns injured workers to the provider of OCM’s choosing, thus further ensuring it maximizes its revenue by assigning these injured workers to the providers who have acceded to the deepest discounts. In doing so, OCM illegally provides them a preference in receiving such referrals. The payment OCM receives from its workers’ compensation payor clients for its management services is tied to the number of referrals OCM makes and the size of the discounts OCM obtains from its contracted health care professionals who care for injured workers.