Here are five things to know about the rules.
1. Assembly Bill 72, which took effect July 1, forbids balance billing for out-of-network care at in-network facilities.
2. Older California statutes forbid balance billing in emergency situations.
3. Insurers are required to accept complaints for suspected surprise billing and have 30 days to solve the problem. If consumers are dissatisfied with the result, the state’s Department of Managed Health Care will step in.
4. California’s balance billing legislation doesn’t include self-insured health plans regulated by the U.S. Department of Labor under the Employee Retirement Income Security Act, which covers an estimated 40 percent of those with commercial insurance in the state.
5. Only 15 states have some protections against balance billing to date and only six have comprehensive protections.
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