CompFox AI Summary
The Workers' Compensation Appeals Board (WCAB) reconsidered a decision regarding lien claimant Monrovia Memorial Hospital's claim for additional payment for services rendered to applicant Silvestre Lopez Trujillo. Although Monrovia Memorial Hospital is a long-term acute care hospital exempt from standard fee schedules and entitled to reasonable cost basis payment, it failed to prove its billed amount was reasonable. The WCAB found the hospital's claimed charges of $149,382.54 were grossly disproportionate to the $34,611.32 estimate for comparable services at another facility. Therefore, the WCAB rescinded the original findings and substituted new ones, finding the hospital was reasonably compensated and not entitled to further payment.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board (WCAB) reconsidered a decision regarding lien claimant Monrovia Memorial Hospital's claim for additional payment for services rendered to applicant Silvestre Lopez Trujillo. Although Monrovia Memorial Hospital is a long-term acute care hospital exempt from standard fee schedules and entitled to reasonable cost basis payment, it failed to prove its billed amount was reasonable. The WCAB found the hospital's claimed charges of $149,382.54 were grossly disproportionate to the $34,611.32 estimate for comparable services at another facility. Therefore, the WCAB rescinded the original findings and substituted new ones, finding the hospital was reasonably compensated and not entitled to further payment.
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