* A group of more than 80 western Pennsylvania pharmacists on July 28 won a judgment in the Allegheny County (PA) Court of Common Pleas preventing UPMC Health Plan and its Medicaid HMO, Best Health Care, from cutting reimbursement rates. The original dispute arose last fall when UPMC told pharmacies that a "processing error" in claims had resulted in an incorrect reimbursement rate being paid. Therefore, to correct for the error, UPMC said the rate was to be cut, an action the pharmacists' lawsuit sought an injunction against. Grogan Graffam, attorneys for the plaintiffs, says Judge Judith Friedman ruled that each prescription dispensed represents a binding contract that can't be altered once the claim for it has been transmitted electronically, so correcting for such an error would have to take place between the health plan and its claims administrator. Call Grogan Graffam's Dennis Roman at (412) 553-6325 or UPMC's Bill Sawchak at (412) 454-8545.
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