Number of California's in-network specialty physicians increased after passage of surprise-billing law, insurance group says

California has seen the number of in-network specialty physicians increase by 16 percent, on average, since the state passed a law to address surprise medical bills, according to a study by America's Health Insurance Plans, a trade association.

California implemented the law in 2017 to address out-of-network bills for nonemergency physician services at in-network hospitals.

The law — which includes a benchmark, locally negotiated market payment rate for out-of-network care — sparked concerns that insurance providers would reduce the number of in-network specialty physicians, according to America's Health Insurance Plans.

The group examined 11 health plans, representing 96 percent of covered lives in the fully insured commercial market statewide, to see how the number of in-network specialty physicians has changed since the law's implementation. Insurance providers offered the total number of in-network providers between July 1, 2017 and July 1, 2019.

America's Health Insurance Plans said researchers found that the number of physicians in provider networks — including physicians in general surgery, emergency medicine, anesthesiology, diagnostic radiology and pathology — was 116 percent, on average, of the level before the law took effect. All individual specialties saw growth or remained essentially flat, according to the study.

 

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