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.

When Cuddy arrives at the hospital, she rushes to deal with a problem in the pharmacy where double the amount of ephedrine has been sent. Then she goes 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 so House's diagnostic team could use the O.R., and subsequently, he threatens to file a charge if it harms his patient's well-being.

Cuddy arrives late to her meeting with insurance executive Eli Morgan, and presents the hospital's final offer with a demand for 12% increase in reimbursements. Eli rejects it and Cuddy plays hardball by claiming to terminate their contract with his company. She gives him until the 3 PM to accept her offer.

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 she defends her decision to demand the 12%. 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, for which he is sure has cancer-fighting qualities, so that he can get his reimbursement. Cuddy refuses, and the patient walks out calling her a bitch. When finished with this unpleasant encounter, 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. 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 was a vital digit.

Cuddy confronts Gail, the pharmacy technician who was stealing the ephedrine to lose weight. She apologizes for forging pharmaceutical orders and begs for a second chance. Cuddy doesn't report the crime to the DEA, but fires Gail.

At lunchtime, Cuddy asks Wilson for his advice on the insurance company, and Wilson suggests she consult House, who is, according to Wilson, 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 cancer patient with malaria because he claims it is the cheapest way to deliver hyperthermia. Then, Cuddy questions whether or not House bet someone he could use it as a diagnostic tool.

Lucas visits Cuddy at the hospital and lets her know that Rachel doesn't have a fever but does have a small rash. Cuddy goes to a restaurant where the CEO of the insurance company is having lunch. She appeals to him about PPH's proposal and she threatens to defame his greed in front of the press. 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 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 refuses to back down and retaliates by threatening that the hospital would counter-sue and get paid, even if it means taking the man's house.

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 makes them stop and summons them to her office, but she deals with the duplicitous pharm tech first. Gail is no longer the sobbing victim. Gail is prepared to lie to get out of her crime.

Exasperated, Cuddy is sitting in her car in the parking lot when House comes. House says that the breast milk guy finally found a doctor to give him the prescription. 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. 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. 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, causing her to miss the elevator. The insurance representative arrives, but this time he gives a shocked Cuddy her twelve percent increase from the insurance company with congratulations, which makes her shout with joy.

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 with a smile. The final cut shows Cuddy lying in bed with Rachel and Lucas, apparently reflecting a moment of idyll. Suddenly, Cuddy's pager starts to beep—this day seems to never end...