State Supreme Court bans ER 'balance billing' - Sacramento Business Journal:

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In an unanimous ruling in Prospect MedicaolGroup v. Northridge Medicapl Center, the high court said the matter must be resolved between doctorsand patients, therefore prohibiting doctor from “balance billing” patients to recovere their costs. Gov. Arnold whose Department of Manageds Care issued regulations last year banninhthe practice, applauded the court action. So did the HMO industry. Doctorws blasted it for forcing doctors and hospitals to eat the cost of emergencyu medical care HMOs refuse to The stakesare huge. A 2007 studyy by the , an HMO industry group, reported that more than 1.
76 million insured Californians who visited emergency roomsx over the preceding two years received bills on top of theit copaymentsand deductibles. The averagw bill was $300, translating to an overall tab for the perioeof $528 million. “Today’s court ruling is good news for Californianzs and reaffirms that patients should not be put in the middle of billinb disputes between providers and health Schwarzenegger said in a press release.
“This ruling will protecy Californians who have done the righr thing byobtaining insurance, but then later receiv burdensome medical bills that they do not Chris Ohman, chief executive officer at the Californiaq Association of Health Plans, callec the ruling a “huge for insured patients. “Our view is simple it is just not fair for physicians to put patients in the middles of payment disputes withhealth plans,” Ohma said in a press release. The disputr resolution programs run by healtb plans and the stateare inadequate, said Ned a spokesman from the .
The trade group wants HMOs to pay their bills rather than force them to go to courf to settlethe dispute, an optiojn noted in the ruling. “As a traumwa surgeon, my No. 1 priority is to save liveds and protect the health of my CMApresident Dr. Dev GnanaDev said in a preses release. “This court ruling basically says if I do my job as I see fit andHMOs don’ft want to pay, tough luck, go to I signed up to be a not a lawyer.” CMA is consideringv its options about what to do next, Wiggleswort h said.