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California bans balance billing

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Capping years of debate, a new law just went into effect in California banning balance billing, a landmark measure that may further shift the balance of power in the direction of health plans. Several legal challenges regarding balance billing are going before state courts soon, but in the meantime, some hospitals are panicking about how to make ends meet when insurers underpay them.

Among the key backers of the bill was the state's Department of Managed Health Care, which argued that under existing state laws, consumers were having their credit ruined because they didn't pay the hospital's bill, or were paying out of pocket because they didn't know that they weren't responsible for that payment.

Many doctors and hospitals, however, are claiming that this law is unfair. They claim that the Department of Managed Health Care should be acting more quickly against the insurance companies when they underpay or make late payments, instead of going after the doctors themselves, who are just trying to get the money they need to keep in business.

To learn more about this law and the court battles:
- read this L.A. Times piece

Related Articles:
CA sues Prime Healthcare for balance billing insured patients
CA law would ban balance billing for ED services
CA providers, officials fight over balance billing

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Comments

I think the problem of balanced billing should be solved by forcing the insurance companies into capitation of their fee schedule. I do not think that this should be done by the government. These fees should be set by professional medical boards in a fair and equal manner with arbitration rules. The only role of the government would be to force the insurance companies to accept this fee struture from this boards.

For the docs and the hospitals there will never be enough money. They would bill 100k for every medical event if they thought they could get away with it. These groups are totally and completely disconnected with the economic burdens of the community employers who are trying to finance their bills.

Balance billing has been illegal for a long time. This latest court fight probably cost California taxpayers five (5) milling+. Doctors and hospitals overcharge all the time, think about this, if you paid cash at a doctors office or hospital that they would give you a discount believe it or not they routinely charge cash patients double and triple what they charge insurance companies, this is a fact “ask”, you can also check on the web for what a particular thing costs an insurance company, you will get pissed. If they were really doctors that cared patents would not be so un-trusting of the medical industry. If you have ever been hospitalized you know that they always keep you over drugged, the reason is to keep you sleeping in there beds which if you have insurance they choke the crap out of, in other words they are simply using your body to collect money that they deserve because they think its ok.
What really needs to happen with all medical in the USA is it needs to be state and federal ran like the rest of the world. It would be much better here because guess what, this is the USA. If it was then schooling would be paid back and things would be voted on by the people and not by a committee of overpaid hypocrites. If you think this is a lone opinion look around at all the blogs.

Mr Anonymous above couldn't be more wrong. He indicates that 'doctors and hospitals overcharge all the time'. The reality is that the insurance companies have both created medical inflation and reduced price transparency in the system. Its not the hospitals fault that the insurance companies have the upper hand and have lowered the prices far below what the cash-paying patient pays. In many cases, the hospital is even legally forbidden from offering a price below what Medicare pays - since Medicare will then insist that that, by law, should be the price offered to them.

Doctors can both care about patients and care about making money. Indeed, they are required to do so, as any service that is also a business.

Government run health care would be far worse - but you must understand that we ALREADY HAVE government run health care, to a large degree. That is precisely the origin of the problem - government (and other third partys) putting themselves between the doctor and the patient.

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