California bill targets surprise ER billing

A proposed bill in California aims to strengthen protections against surprise medical bills, particularly in emergency situations, according to California Healthline.

The proposal — introduced by state Assemblyman David Chiu, D-San Francisco — addresses balance billing. This occurs when a patient receives care from an out-of-network provider and is billed for the difference between what the patient's insurance company decides to pay and what the provider believes the care is worth. Balance billing also occurs when a patient is unable to choose the facility they visit. This often happens in medical emergencies.

Under the California proposal, out-of-network hospitals would be limited to what they could charge for emergency care, according to California Healthline.

These hospitals would only be allowed to charge privately insured emergency patients their in-network copayments, coinsurance and deductibles. Additionally, they could only charge insurance plans a certain rate for each service, depending on the region. Billing disputes would be settled between health plans and the hospital.

Hospitals oppose the bill — which would cover all insurance plans, regardless of the agency that regulates it — describing it as a form of rate-setting, according to California Healthline.


More articles on healthcare finance: 

Atrius Health posts $38.7M operating surplus for 2018, credits value-based care success
Federation of American Hospitals CEO Chip Kahn's 3 takeaways on surprise medical bills
Trump is drafting order to force healthcare cost disclosures, Wall Street Journal reports

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