California Supreme Court Says Keep Patients out of ER Bill Disputes

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(Sacramento, CA)
Thursday, January 8, 2009
The California Supreme Court ruled Thursday to keep patients out of some hospital billing disputes. The ruling deals with patients who have HMO insurance and get treatment in emergency rooms not on their health plan. It says doctors can no longer directly charge patients to make up for costs they can’t get from HMOs. It’s a practice called “balance billing.”
Chris Ohman with the California Association of Health Plans says the court’s ruling is a victory for patients. 
“It’s just not fair for patients to be put in the middle of payment disputes with health plans. The California Supreme Court has gone one step farther and said it’s illegal.”
Ohman says he hopes the next step will be to create an independent review board to work out billing arguments between doctors and health plans.
In October the California Department of Managed Health Care started to crack down on providers who try to unfairly bill patients.