Thursday, July 27, 2017

OCMA Blog

Tell regulators how new out-of-network billing and payment law will affect your practice

On July 1, 2017, a new law (AB 72) will take effect that will change the billing practices of non-participating physicians providing non-emergent care at in-network facilities including hospitals, ambulatory surgery centers and laboratories. The law, signed in 2016, was designed to reduce unexpected medical bills when patients go to an in-network facility but receive care from an out-of-network doctor.
  

To ensure health plans and insurers do not game the system to pay artificially low reimbursement rates to physicians, we need all physicians to take action by contacting the health plan/insurance regulators to express the importance and potentially negative impacts of this law if not implemented correctly.

A sample letter is provided on the CMA website.
 
NOTE: For this effort, phone calls will not be as effective.  We are asking that you submit your statement via email or mail so that there is a tangible record of your comments.  

Description
AB 72, passed by the California Legislature and signed into law this year, would require an “interim payment” to physicians and place limitations on the ability of physicians who do not contract with a patient’s health plan or insurer to collect their full billed charges for non-emergency services performed at a contracting health facility.

 


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