Government
Medical associations file brief in Calif. balance-billing lawsuit
NEWS IN BRIEF — Posted Feb. 19, 2007
Taking away doctors' ability to bill patients for the balance of emergency service costs that health plans do not cover will further hinder access to emergency care in California, states an amicus brief the American Medical Association/State Medical Societies Litigation Center jointly filed with the California Medical Assn. in January.
The pending California Supreme Court case will determine if a state law that bans balance billing by in-network physicians applies to noncontracted emergency doctors. An appeals court in February 2006 ruled that it does not, and doctors are seeking for that to be upheld. The managed care organization in the case and California's Dept. of Managed Health Care say balance billing is illegal under the law, which includes "implied" contracts with out-of-network doctors.
Physicians say health plans are not contracting with enough emergency specialists. Patients often get care from out-of-network doctors who must bear the cost when insurers do not pay reasonable rates for the federally mandated care, the brief states.
No date is set for oral arguments in Prospect Medical Group v. Northridge Emergency Medical Group.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/02/19/gvbf0219.htm.
