Curious to see how this works out.
http://www.modernhealthcare.com/art...ia-surprise-bill-legislation-could-spur-other
http://www.modernhealthcare.com/art...ia-surprise-bill-legislation-could-spur-other
California medical consumers will enjoy strong new protection against surprise out-of-network medical bills starting next July, under a hard-fought bill overwhelmingly approved by the state legislature this week. It's widely expected that Democratic Gov. Jerry Brown will sign it.
Under the bipartisan bill, AB 72 (PDF), authored by Democratic Assemblyman Rob Bonta, patients who received care in in-network facilities would have to pay only in-network cost sharing. This would apply just to non-emergency care, since emergency physicians in California already are barred from balance billing patients. The bill’s provisions would not apply, however, to self-insured employer health plans, which are shielded from state regulations by the federal Employee Retirement Income Security Act.
Health plans would pay non-contracting physicians the plan's average contracted rate or 125% of the Medicare rate, whichever is greater. Doctors could appeal that through a binding independent dispute resolution process, which the state Department of Managed Health Care will establish.