Emergency department doctors and hospitals in California can no longer directly bill insured patients for charges HMOs refuse to pay. Last week, the state’s highest court barred balance billing and contended that ER doctors and HMOs must iron out their disagreements. The responsibility should not fall on patients. (Source)
In a press release, Governor Arnold Schwarzenegger wrote: “This ruling will protect Californians who have done the right thing by obtaining insurance, but then later receive burdensome medical bills that they do not owe.”
Perhaps the ruling will force the two parties to come to fairer terms instead of defaulting to billing patients; however, the ruling didn’t settle the “reasonable and fair” payment issue. Regardless, it certainly will ease the burden on patients, but that must be balanced with the doctors’ need to be paid and the HMOs’ responsibility to pay.
