Balance billing ban upheld

In yet another chapter in the ongoing saga of balance billing, a judge in Sacramento recently affirmed state regulations looking to protect consumers from the practice. Last month, physicians in California challenged the ban put on balance billing by the state, citing that doctor's shouldn't be punished for the stinginess of HMOs. Subsequently, Francisco J. Silva, the general counsel to the California Medical Association, wanted the California Department of Managed Health Care (DMHC) to go after HMOs, forcing them to pay more.

Still, Sacramento Superior Court Judge Michael P. Kenny, who "tentatively sided with the state" on the matter in November, upheld the department's regulations on Tuesday, even after hearing arguments from both the California Medical Association and the California Hospital Association.

Cindy Ehnes, director of the CDMHC, believes the ruling will help providers to get their money in a timely fashion, as well as protect consumers. "All along, the Governor and his Administration's goal has been to protect consumers from unfair and illegal balance billing," she said.

But don't expect the CMA to take the finding lying down; they more than likely will appeal the case.

For more on balance billing:
- check out the Sacramento Bee article

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