Cuddy rises early to find Lucas is not in her bed. She quickly goes about her morning of tending to a sick Rachel as she tries to get ready. The nanny Marina arrives to deal with the baby, and Cuddy is about to leave for work when Lucas arrives after an all-night stakeout. Although she's late, she agrees to a morning quickie. As they start to get intimate, her blackberry rings with an emergency page from House. Cuddy ignores it and they continue. A minute later, she rolls over, frustrated. Lucas asks for another go, but she gets up to leave.
When Cuddy arrives at the hospital, House accosts her to say that he was with Lucas on the stakeout during the night. He bet Lucas that he could stop their morning "routine" with a page since Lucas told him they do it every morning. Cuddy won't give him the facts to help his wager.
Cuddy rushes to deal with a problem in the pharmacy where double the amount of medication has been sent. She inquires whether the meds were Vicodin, but it was ephedrine. Cuddy's 8:30 am meeting is waiting in her office, but she needs to check into the O.R., where Dr. Hourani, mid-surgery, complains that House had bribed the plant to turn up the air conditioner to hurry him up. Hourani threatens to file a charge if it hinders his liver transplant patient's well-being. Cuddy says she will deal with it.
After House lets her know that he needs that O.R., Cuddy gives instructions to her nanny Marina about lowering Rachel's temperature. She arrives late to her meeting with the insurance executive Eli Morgan, and presents the hospital's final offer with a demand for twelve percent more reimbursements. Eli rejects it and Cuddy plays hardball by claiming to terminate their contract with his company. She gives him until the afternoon to accept her offer.
By ten am, Cuddy writes up new scripts for the Customer Center call reps and rushes to the Clinic. House waits outside her office to ridicule her about the deal she made with the insurance rep. He applauds her for giving Eli an ultimatum. Thirteen and Taub stop House with news of their patient's heart rate plummeting. Cuddy is one step ahead and, before House can answer, warns him not to infect the patient with malaria as a cure.
Dr. Thomas tells Cuddy he is annoyed that he had to hear Hourani's complaints and blames Cuddy for appeasing House at every turn. He had to take Chase on his team because of her urging. Thomas besieges her to focus on her job and not put out House's fires. Cuddy goes into the hospital board meeting and gives them the news that she doesn't have a contract with the insurance company. The board members are unhappy, but Cuddy defends her decision to demand the twelve percent. She is confident that Eli will give in, but it is made clear that she will be fired if her plan fails.
When a doctor doesn't show up for clinic duty, Cuddy fills in. She deals with a cancer patient whose oncologist won't give him a prescription for breast milk, which he is sure has cancer-fighting qualities, so that he can get reimbursement. Although she feels for the man, Cuddy refuses. The patient calls her a bitch under his breath. Nurse Regina tells Cuddy that the vascular surgeon called in a replacement with no privileges. Cuddy has her call another doctor who owes her a favor.
A lawyer waiting in Cuddy's office alerts her that he is suing the hospital and Chase for reattaching his client's thumb without his consent. The client and the insurance company do not want to pay. Cuddy checks in with Chase, who says that, although his patient wanted the cheapest option, he performed the reattachment surgery anyway because his call was that it is a vital digit.
Cuddy confronts Gail, the pharmacy technician who was stealing the ephedrine to lose weight for her husband. The sobbing woman apologizes for forging pharmaceutical orders and begs for a second chance. Cuddy won't report the crime to the DEA but, regrettably, she has to fire Gail.
At lunchtime, Cuddy relays her already busy day to Wilson and says she cannot get hold of her nanny. She asks his advice about the insurance company, and Wilson suggests she consult House -- the "master manipulator who always gets what he wants." She brings her salad back to her office but House is there. He wants to treat his boil patient with malaria because he claims it is the cheapest way to deliver hyperthermia. With the second mention of malaria, Cuddy questions whether House bet someone he could use the disease as a diagnostic tool. He says that the real bet is her giving an ultimatum to the insurance company.
Lucas surprises Cuddy at the hospital and she makes a remark about him talking about their sex life. He lets her know that Rachel doesn't have a fever but does have a small rash. When Cuddy phones her nanny again, Lucas' pocket rings. He accidentally took Marina's cell and had turned off the ringer earlier. To ease Cuddy's stress, Lucas offers to dig up some dirt on Eli, but Cuddy wants a different piece of information.
Cuddy goes to a restaurant where the CEO of the insurance company is having lunch. She appeals to him about PPH's proposal. She says that she might have to tell the press that their rich company would look bad if it appears they are cutting costs unnecessarily. The CEO doesn't budge.
The hospital's pharmacist lets Cuddy know that pharm tech Gail had stolen ten cases of ephedrine. Cuddy realizes that this wasn't about losing some weight. Gail had enough drugs to supply a meth lab.
Eli comes to Cuddy's office on orders from the CEO, who has agreed to an eight percent increase. She demands the twelve she asked for, but Eli says they will never agree to such a preposterous number. He suggests she take the deal on the table.
Cuddy sits in a stairwell alone to think. When she emerges, House is waiting at the door. He didn't use malaria to treat the patient because Foreman overruled him. Cuddy finally asks House's advice about taking the insurance company's reply with eight percent. He questions why she would put her job on the line to prove a point. She notes that House would do just that.
Cuddy sees that it is now three o'clock, the deadline she gave to the insurance company. There is still no counter offer. She addresses the gathered hospital board members and doctors about terminating the contract. PPH will no longer accept patients from the insurance company. The room fills with buzz.
Foreman announces that they have a liver match for their patient. Yet House doesn't want to use Dr. Hourani for the surgery. House wants Chase to do it in order to prove to the doubting Dr. Thomas that Chase was his department's best surgeon. Cuddy cannot believe that she has to work with such childish behavior.
Cuddy interrupts House's massage and orders him to get his department under control. He warns her that the insurance company won't buckle under her PR pressure so quickly. They will retaliate with force.
Cuddy tries to rationalize with the lawyer and his client with the reattached thumb. She proposes that if they drop the lawsuit, the hospital will resubmit the claim and pay half his deductible. The lawyer is furious that his client would still pay anything, but Cuddy is adamant that they have secured the client's ability to have a normal life by saving his thumb. The man says he cannot pay because his family is so in debt. He thinks he would be in better shape without his thumb and its medical bills. Cuddy explains that her doctors do good work and deserve to be paid. The lawyer threatens to go to court.
Cuddy gets paged to the pre-op area where Foreman and Thirteen are trying to break up a fistfight between Chase and Dr. Thomas. She whistles for them to stop and summons them to her office like schoolchildren, but she must deal with the pharm tech first. Gail is no longer the sobbing victim. She intimates that she will squeal to the DEA about House forcing her to sell meds and that Cuddy was protecting her lover House. Gail is prepared to lie to get out of it, and calls Cuddy a bitch.
Exasperated, Cuddy is sitting in her car in the parking lot when House raps on the window. She breaks the silence by saying that he owes Lucas the wager -- she was having sex when he called this morning. House says that the breast milk guy finally found a doctor to give him the prescription. "If it works, that's way better than malaria," House shrugs, not giving himself up. Cuddy confesses that she thought the insurance company was the one who was bluffing. House knows she won't quit because the hospital matters to her. He also says he thinks Gail is a sociopath, which gives Cuddy an idea.
Cuddy appeals to Gail to admit the truth because she knows she is good deep down inside. Gail calls her an idiot, and says that she has been stealing almost immediately after she was hired. Gail is convinced that Cuddy isn't tough and will do anything to protect her own job as hospital administrator. "If I go down, you're going down," Gail says menacingly before she exits. Cuddy takes the flower that was sitting on her desk and hands it to Nurse Regina. She explains that Lucas gave her the hidden microphone inside of it, and instructs Regina to pass the recording of Gail's admission to the DEA. With one victory today, Cuddy goes to turn in her resignation to the board in hopes that they can still get their eight percent from the insurance company.
Marina finally calls to tell Cuddy that Rachel is better. Eli shows up and calls Cuddy a bitch. But this time he gives a shocked Cuddy her twelve percent increase from the insurance company with a congratulations. Nurse Regina smiles as she hears Cuddy's scream of delight from the hallway.
The board and doctors clap when Cuddy elatedly brings them the good news. House smiles to himself.
As Cuddy packs up for the night, she sees a check on her desk. The thumb replacement patient has delivered the first installment of his payment for the surgery. Cuddy rips up the check.
That night, Cuddy lies in bed with Lucas and a sleeping Rachel. He puts his hand on her butt. She moves it away and then moves his hand back. Her phone dings. "You gonna get that?" Lucas asks.