Don't copy California's surprise-billing law, physicians there warn federal lawmakers

Amid federal discussions about surprise billing, California physicians are warning lawmakers against modeling federal legislation after the state's law, according to a new survey by the California Medical Association.

The California law, implemented in 2017, addresses unexpected patient bills for out-of-network, nonemergency physician services at in-network hospitals by paying out-of-network health professionals a benchmark, locally negotiated market rate.

The California Medical Association recently surveyed 855 physician practices representing thousands of physicians, to gauge their feelings about the state legislation.

Four survey findings:

1. Nearly all respondents (94 percent) said a federal law modeled after California law will lead insurers to terminate contracts with physicians.

2. Ninety-one percent of respondents said a federal law modeled after the California law will lead to large hospital systems or private equity groups gobbling up more independent physician practices.

3. Eighty-eight percent of respondents said the state's surprise-billing law allowed insurers to shrink physician networks, reducing patient access to in-network physicians.

4. Ninety-two percent of respondents said it's harder for them to negotiate fair and reasonable contracts with insurers due to California's law.

Read more about the survey findings here.


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