State Fund Provider-Payor Disputes


Retained by State Compensation Insurance Fund

State Compensation Insurance Fund (State Fund), a non-profit enterprise that provides workers’ compensation insurance to California employers, faces claims by multiple ambulatory surgical centers. The surgical centers allege that they have received unreasonably low reimbursement from State Fund for facility fees billed in connection with workers’ compensation patients and seek payment from State Fund for the difference between their billed charges and the amount State Fund had reimbursed them. State Fund has retained Professor Daniel Kessler of Stanford University and Cornerstone Research to analyze reimbursement methods for the claims at issue and to assess the validity of the analyses of the plaintiffs’ experts.

Case Expert

Daniel P. Kessler

Professor of Political Economy, Stanford Graduate School of Business;
Professor of Law, Stanford Law School;
Professor (by courtesy) of Health Research and Policy, Stanford School of Medicine;
Senior Fellow, Hoover Institution and Stanford Institute for Economic Policy Research, Stanford University;
Senior Advisor, Cornerstone Research