In the Wall Street Journal (12/4) Health Blog, Victoria Knight wrote, "Some state regulators have cracked down" on balance-billing, which occurs when patients are held responsible for "charges their insurers refuse to pay, but hospitals and doctors demand." In California, the Superior Court "upheld regulations recently enacted by the state's Department of Managed Health Care designed to protect patients from the billing practice in medical emergencies."
The San Francisco Business Journal (12/5, Robertson) adds that the regulations, which went into effect Oct. 15, "define balance billing as an unfair billing practice prohibited by state law." The rules are contested by a coalition of health providers, including the California Medical Association (CMA), who "filed a petition Sept. 26" to stop them from going into effect.
"The hospitals and medical groups argued the order was unfair and could undermine the networks and agreements already in place between insurers and their member hospitals," the Sacramento Bee (12/4, Calvan) noted. According to a spokesman, the CMA, "which had argued that the regulations don't do enough to require insurers to pay the full amount owed, will likely appeal the ruling," Modern Healthcare (12/5) points out.
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