EXHIBIT F 

Case: 1:20-cv-02561 Document #: 28-6 Filed: 06/16/20 Page 1 of 6 PageID #:536
In the Matter of the Arbitration Between: 

MERIDIAN HEALTH PLAN OF ILLINOIS, 

INC., 

Claimant, 

and 

SAINT ANTHONY HOSPITAL. 

Respondent. 

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American Arbitration Association 

Commercial Arbitration Rules 

ARBITRATION DEMAND 

Via Certified U.S. Mail to: 

Saint Anthony Hospital 

Attn. Randy Stein 

2975 W 19th Street 

Chicago, IL 60623 

PLEASE TAKE NOTICE that claimant Meridian Health Plan of Illinois Inc., 

%lBS`WRWO\m&' Pg Wba Obb]`\Sga' A]QYS A]`R AAE' VS`SPg RS[O\Ra O`PWb`ObW]\ ]T O\g O\R OZZ RWa^cbSa

bVOb VOdS O`WaS\ PSbeSS\ BS`WRWO\ O\R GOW\b 7\bV]\g =]a^WbOZ %lGOW\b 7\bV]\gm& W\ Q]\\SQbW]\

with the Illinois Hospital Agreement dated October 1, 2014 (the l=]a^WbOZ 7U`SS[S\bm&' eVWQV Wa

attached as Exhibit A. In support of its arbitration demand, Meridian states the following: 

BACKGROUND 

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government-sponsored healthcare plans to low-income individuals, families and children, 

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Medicare contracts with state and federal agencies. (See, e.g., https://corp.mhplan.com/en/.) 

Case: 1:20-cv-02561 Document #: 28-6 Filed: 06/16/20 Page 2 of 6 PageID #:537
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2. Meridian has no commercial products, and thus receives all of its revenue from 

state or federal governments. Meridian is highly regulated and therefore has a stringent burden to 

ensure the proprietary of any payments it makes to healthcare providers like Saint Anthony. 

3. In 2017, the State selected Meridian as one of seven MCOs authorized to administer 

managed care services to Medicaid beneficiaries through a contract with the Department of 

Healthcare and <O[WZg GS`dWQSa %l=<Gm& T]` bVS GbObS ]T >ZZW\]Wa %bVS lGbObSm&)1 Under this 

contract, Meridian administers benefits on behalf of Medicaid members who reside in the State 

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per month basis. Meridian is then responsible for contracting with providers (like Saint Anthony) 

and paying for Medicaid-SZWUWPZS VSOZbVQO`S Q]aba W\Qc``SR Pg BS`WRWO\na [S[PS`a' ^c`acO\b b]

the terms agreed to by Meridian and those providers. See, e.g., Midwest Emergency Assocs.-Elgin 

Ltd. v. Harmony Health Plan of Ill., Inc., 888 N.E.2d 694, 696 (Ill. App. Ct. 2008) (generally 

discussing Medicaid managed care arrangements). 

The Hospital Agreement.

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October 1, 2014 and continuing through the present. (Ex. A.) Among other things, the Hospital 

Agreement requires Saint Anthony to provide certain authorized, covered medical services to 

BS`WRWO\na [S[PS`a) GOW\b 7\bV]\g [cab bVS\ acP[Wb bW[SZg QZOW[a T]` ^Og[S\b b] BS`WRWO\ W\

a prescribed manner. (Id. at §§ 2, 4.) Meridian then processes, adjusts, pays, or denies the claims 

in compliance with the time frames and other requirements specified by the parties. (Id. at § 4.) 

1

 Although HFS originally chose seven MCOs, there are currently only six MCOs 

contracted with HFS. 

Case: 1:20-cv-02561 Document #: 28-6 Filed: 06/16/20 Page 3 of 6 PageID #:538
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5. HVS ^O`bWSa [cab l[OYS O U]]R TOWbV STT]`b b] \SU]bWObS O\R resolve all billing 

RWa^cbSa)m %Id. at § 4.9.) In the event they are unable to do so, the Hospital Agreement requires 

l8W\RW\U 7`PWb`ObW]\)m (Id. at §§ 6.1, 6.2.)2 I\RS` bVWa =]a^WbOZ 7U`SS[S\b' lSWbVS` ^O`bg [Og

seek binding arbitration either under the Rules for Arbitration of the Alternative Dispute 

Resolution Service of the American Health Lawyers Association or the American Arbitration 

7aa]QWObW]\)m %Id) Ob i 1)-)-)& l8]bV M^NO`bWSa OU`SSMRN b] PW\RW\U O`PWb`ObW]\m O\R bVOb acQV

O`PWb`ObW]\ leWZZ bOYS ^ZOQS W\ O [cbcOZZg OU`SSR c^]\ Z]QObW]\)m %Id.) 

6. Because the parties agreed to arbitrate under the American Arbitration Association 

%l777m& FcZSa' bVS ^O`bWSa VOdS OcbV]`WhSR bVS 777 b] OR[W\WabS` bVS 7`PWb`ObW]\) See AAA 

Commercial Arbitration Rule R-2. 

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7. In Summer 2019, certain disputes arose between the parties. These disputes 

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Hospital Agreement. In an effort to resolve those disputes, the parties exchanged information and 

held meetings. 

8. On August 1, 2019, Meridian and Saint Anthony both confirmed in writing their 

commitment to work together to resolve all outstanding disputes. To that end, throughout the 

remainder of 2019 and in 2020, the parties continued to communicate in writing and orally 

regarding the disputes. I\T]`bc\ObSZg' V]eSdS`' bVS ^O`bWSan STT]`ba eS`S c\acQQSaaTcZ)3

2

 Meridian and Saint Anthony entered into related practitioner agreements also effective 

October 1, 2014. To the extent applicable, those agreements also control billing and payment 

disputes and include an arbitration provision. (See Ex. B and C.) 

3

 Section 6.2.1 of the Hospital Agreement provides that when negotiations fail, the parties 

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mediation of the ^O`bWSan RWa^cbSa)

Case: 1:20-cv-02561 Document #: 28-6 Filed: 06/16/20 Page 4 of 6 PageID #:539
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The Federal Court Complaint. 

9. While tVS =]a^WbOZ 7U`SS[S\b `S_cW`Sa bVS ^O`bWSan RWa^cbSa b] PS `Ssolved through 

binding arbitration, Saint Anthony has instead sought to resolve the disputes in court. Specifically, 

on April 27, 2020, Saint Anthony filed a lawsuit in the United States District Court for the Northern 

District of Illinois, Case No. 20 CV -01, %bVS lAOeacWbm&) HVS 9][^ZOW\b Wa ObbOQVSR Oa ;fVWPWb

D. 

10. Although Saint Anthony filed the Lawsuit against Theresa Eagleson, in her official 

capacity as Director of HFS, the Complaint raises numerous disputes against Meridiankall of 

which arise under the Hospital Agreement. The disputes set forth in the Complaint include, for 

example: 

 Claim Denials. GOW\b 7\bV]\g OZZSUSa bVOb Wba QZOW[a lVOdS PSS\ RS\WSR Pg bVS

MCOs [including Meridian] at rates that are multiples of those Saint Anthony 

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SfO[^ZS lBS`WRWO\*=O`[]\g B9D `SQS\bZg RS\WSR O ^SRWOb`WQ QVO`US T`][ GOW\b

Anthony because the claim did not include the birth weight, which was irrelevant 

b] bVS aS`dWQS ^`]dWRSR)m (Id. at ¶ 47.) Sections 4.4 and 4.5 of the Hospital 

Agreement govern such claim denials, rejections, and adjustments. (See Ex. A.)

 Delays in Payment. GOW\b 7\bV]\g OZZSUSa bVOb lMbNVS B9Da MW\QZcRW\U BS`WRWO\N

regularly delay making payments for claims even after the MCO determines that 

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ROga b] - gSO`a b] PS ^OWR Pg B9Da)m %;f) : Ob j 0,)& GOW\b 7\bV]\g OZa] OZZSUSa

bVOb lBS`WRWO\ VOR O\ OdS`OUS []\bVZg `ObS ]T ]\Zg .4)4$ ]T claims paid within 30 

days, with some months with no claims that were submitted by Saint Anthony paid 

eWbVW\ .+ ROga)m (Id. at ¶ 72.) Sections 4.3, 4.4, and 4.5 of the Hospital Agreement 

establish and govern such timing requirements for Meridian to process and pay 

GOW\b 7\bV]\gna QZOW[a) %See Ex. A.)

 Administrative Burden. Saint Anthony alleges that lMSNOQV B9D W\ bVS GbObSna

managed care system has had different policies and procedures, creating a labyrinth 

for the hospitals to navigate to attempt to get paid for the services they have 

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managed care system [including Meridian] has imposed significant administrative 

Pc`RS\a ]\ GOW\b 7\bV]\g)m %Id.) Sections 1.3 and 4.2.1 of the Hospital Agreement 

establish the administrative requirements for Saint Anthony to submit claims to 

Meridian. (See Ex. A.)

Case: 1:20-cv-02561 Document #: 28-6 Filed: 06/16/20 Page 5 of 6 PageID #:540
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 Lack of transparency. GOW\b 7\bV]\g OZZSUSa bVOb lbVS B9Da MW\QZcRW\U BS`WRWO\N

do not provide itemized claims data showing a breakdown of how it calculated the 

total amount of payment for a claim, leaving Saint Anthony to guess at whether it 

VOa `SQSWdSR bVS TcZZ O[]c\b RcS b] Wb)m %See Ex. D at ¶ 57.) Section 4.5 of the 

Hospital Agreement governs requirements for Meridian to adjust payments on a 

submitted claim. (See Ex. A.) 

11. In addition, in the Complaint, Saint Anthony asks the Court to enter an injunction 

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to Saint Anthony, and for Meridian to use a particular format when issuing claim payment 

remittances. (Ex. D at ¶¶ 87, 96.) 

12. Pursuant to Section 6.2.2, Meridian hereby demands arbitration of all disputes 

arising out of the Hospital Agreement, including but not limited to those set forth above. 

CONCLUSION 

WHEREFORE, Meridian demands arbitration of all disputes arising under the Hospital 

Agreement. At the final hearing, Meridian will request that the Panel make determinations 

regarding all such disputes, including but not limited to those disputes set forth above. 

Dated: June 16, 2020 Meridian Health Plan of Illinois, Inc. 

 By: s/ Ashlee M. Knuckey 

 One of its Attorneys 

Ashlee M. Knuckey 

aknuckey@lockelord.com 

Steven T. Whitmer 

swhitmer@lockelord.com 

LOCKE LORD LLP 

111 South Wacker Drive 

Chicago, Illinois 60606 

Phone: 312.443.0700 

Fax: 312.443.0336 

Case: 1:20-cv-02561 Document #: 28-6 Filed: 06/16/20 Page 6 of 6 PageID #:541