The latest on the California surprise-billing law.
It’s been over two years since California’s surprise-billing law took effect. There continues to be one thing on which consumer advocates, doctors, and insurers all agree on: The law has been effective at protecting many people from bills that may have been saddled with from doctors who aren’t in their insurance network.
The California law is designed to protect consumers who use an in-network hospital or another facility from being hit with surprise bills when cared for by a doctor who has not contracted with their insurer. If such a situation does occur, consumers are responsible only for the copayment or other cost-sharing that they would have owed if they had been seen by an in-network doctor.
“In general, the law is working as intended,” said Anthony Wright, executive director of Health Access California, a patient advocacy group that pushed for the measure, AB-72. “Patients are protected and the providers are getting paid.” However, there are those that disagree. They saw that the laws put constraints on what insurers now pay has given the companies an unfair advantage in negotiations with doctors. This is leading to major changes in the industry that can ultimately affect patients.
Doctors are claiming that the law allowed insurers to shrink physician networks, therefore, limiting patients’ access to in-network doctors. Physicians say that the payment standard made insurers less included to negotiate payments and reduce doctors’ bargaining power.
Do you have questions regarding your health insurance? Then don’t hesitate to contact the experts at Donald Weiss Insurance Services. Our dedicated team is ready to assist you with all your insurance needs.