California balance billing law draws legal fire for price controls

A proposed bill that aims to end balance billing practices in California has drawn scrutiny from industry stakeholders concerned the legislation could harm patient access and market competition.

Bill AB 72 would require physicians bill patients at in-network rates, or 125 percent of the Medicare rate, if a patient inadvertently receives care from an out-of-network physician, such as an assisting surgeon or anesthesiologist.

The bill's opponents argue the legislation violates market deregulation laws that prohibit the government from imposing price controls on private companies.

The Association of American Physicians and Surgeons claims the bill would harm physicians' profitability by denying them larger payments for out-of-network treatment.

The AAPS also claims the bill would harm the uninsured, "as physicians will be forced to cut back on the medical care they provide to the uninsured and to charities."

The state senate has until Aug. 31 to approve the bill.

More articles on legal and revenue cycle management issues:, Experian partner to help labs capture lost revenue
Wake Forest Baptist sees operating gains on RCM performance, patient volume growth
Orlando hospitals eat medical bills, still not enough for some Pulse nightclub victims

© Copyright ASC COMMUNICATIONS 2017. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.


Top 40 Articles from the Past 6 Months