Western Psych medical bills disputed

Will insurance or UPMC pay for victims' treatment?

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Two employees wounded in the Western Psych shooting rampage in 2012 were told by a UPMC executive vice president in the days after the attack that their medical bills would be taken care of by the health care behemoth.

But in recent days, Kathryn Leight and Jeremy Byers were notified by UPMC's workers' compensation arm, UPMC Work Partners, that it planned to collect more than $200,000 paid out for medical care for each of them out of an insurance policy. That money was part of the victims' share of a $500,000 settlement they expect to receive from a State Farm renter's insurance policy on the shooter, John Shick.

More than that, UPMC is claiming that the woman who visited the victims in the hospital, Elizabeth Concordia, listed on its website as an executive vice president of the system, was not a UPMC employee but worked instead for UPMC Presbyterian/Shadyside/WPIC.

Attorneys for Ms. Leight and Mr. Byers on Friday asked Common Pleas Judge R. Stanton Wettick Jr. for permission to depose Ms. Concordia within the next 20 days.

He granted the request.

Ms. Leight, a secretary at Western Psych, was shot in the abdomen, and Mr. Byers, a security guard, was shot in the knee during the March 8, 2012, attack by Shick, who was schizophrenic and sought medical treatment at the facility. Three others were injured and one killed before responding University of Pittsburgh police officers shot and killed Shick.

In the months following the attack, Allegheny County District Attorney Stephen A. Zappala Jr. commissioned a security study of the facility after finding that security there was "negligible or nonexistent."

He found no evidence of any criminal negligence and reported that UPMC had been cooperative in the review and planned about $10 million in safety upgrades at Western Psych and other facilities.

Ms. Leight and Mr. Byers filed civil claims against the hospital system and related entities for failure to properly treat Shick and have him involuntarily committed.

Last week, Judge Wettick granted preliminary objections by UPMC and University of Pittsburgh Physicians, dismissing the majority of claims filed against them.

The only remaining claims are against UPMC for ownership and control of Western Psych, related to allegations of inadequate safety and security there.

The plaintiffs have asked Judge Wettick to certify the case for an immediate appeal to the state Superior Court.

Mark Homyak, who represents Ms. Leight, requested a hearing Friday after UPMC failed to respond to his request for information about Ms. Concordia's actions. Specifically, "was she authorized to make that statement from UPMC? And does UPMC agree to be bound by it?"

The health system has responded only by saying Ms. Concordia does not work for UPMC. It has not answered the other questions.

"Is UPMC going to be allowed to put up that corporate veil?" Mr. Homyak asked the court.

"She doesn't do tasks for the other subsidiaries?" Judge Wettick asked Andrew Tillapaugh, who represented UPMC at the hearing.

"She may do administrative tasks for others," he answered. "She's not an employee, your honor. That's our position. We're respecting that corporate barrier."

UPMC Presbyterian/Shadyside/WPIC is a wholly owned and controlled subsidiary of UPMC.

"I don't care where her paycheck comes from, she's an employee of UPMC," Mr. Homyak responded.

Judge Wettick agreed. "She's an officer of UPMC," he said.

In April, Ms. Concordia, who joined UPMC in 2001, was named the new president and CEO at the University of Colorado Health System in Aurora.

She will begin her position there in September and could not be reached for comment on Friday.

Mr. Tillapaugh told the court that it wasn't UPMC seeking reimbursement from the State Farm settlement, but UPMC Work Partners.

"It's a different entity," he said.

But it sounded like Judge Wettick disagreed.

"If you made a promise you'd take care of it, why are you now seeking subrogation?" he asked.

Mr. Tillapaugh didn't respond. But Mr. Homyak did.

"The incongruity of this action speaks for itself," he said.

Edward Dixon, an attorney who specializes in workers' compensation law, said seeking recovery -- or subrogation -- in a workers' compensation claim is "strictly business."

Although it might appear that UPMC is "insensitive" to the situation, Mr. Dixon said that subrogation is "an everyday practice," he said.

"The chief purpose is to prevent double recovery from the same injury."

But in the case of Ms. Leight and Mr. Byer, there has been no adjudication that theirs are workers' compensation claims.

If, however, that does occur, by statute, UPMC Work Partners would be entitled to recover what it paid out in medical bills or wage loss from any money the plaintiffs receive from any source.

Paula Reed Ward: pward@post-gazette.com, 412-263-2620 or on Twitter @PaulaReedWard.

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