Two Illinois hospitals battle over disclosing insurer agreements

Downers Grove, Ill.-based Advocate Health Care is suing nearby competitor Palos Community Hospital over a request for access to Advocate’s rate agreements with insurers, though Advocate had asked for and received the same information from the Palos hospital, according to the Cook County Record.

In November, Palos had asked for the managed care agreements held by all 12 Advocate hospitals “and other 250 provider entities” over a six-year period as part of a pending 2013 fraud case against Advocate in its role as an insurance provider for its employees. Humana, the manager of Advocate employee health plans, is also named in the suit.  

Advocate’s April 11 complaint said it shouldn’t have to turn over documents that “are among the most confidential and valuable of Advocate’s trade secrets,” as it feels the information is irrelevant to the case.

“That Advocate happens to be a health care system with 12 hospitals in Illinois is not relevant to (Palos’ lawsuit),” the request for an injunction states, according to the Cook County Record. “But Palos is taking advantage of Advocate’s status as a hospital system by seeking through discovery … information relating to Advocate’s rates of reimbursement for the services it provides as a competing health care provider.”

Advocate also argued Palos’ lawsuit can only continue against Humana.

The discovery demand appears to be retribution for Advocate asking for the same reimbursement information from Palos earlier in the case. The Cook County report said Palos admitted in its discovery request in March “it was only seeking (Advocate’s information) because Advocate had sought information from Palos” first.

While Advocate received that rate information from Palos, it has offered to return it and destroy all copies in exchange for Palos dropping its own demand.

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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