CA: State drafts rules to regulate emergency room payments

Los Angeles Times
Posted: April 1st, 2008 by Steve Trinward

“Gov. Arnold Schwarzenegger’s administration has moved to ban physicians and hospitals from billing patients for the cost of services above what their HMOs are willing to pay. Such bills, which patient advocates call a consumer abuse, are the product of a protracted feud between insurers and healthcare providers, principally emergency room doctors, radiologists and anesthesiologists. Those doctors often work in hospitals but don’t have contracts with the same health maintenance organizations that serve the hospitals. Believing the reimbursements they receive from insurers are too low, providers send additional bills to patients for the difference. Many patients wrongly assume that bill is the invoice for their co-payment and is authorized by their HMO.” (04/01/08)

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