Unexpected out-of-network charges targeted by California bill

California legislators have until Aug. 31 to act on legislation aimed at “surprise” medical charges incurred when a specialist isn’t included in a patient’s insurance network.

STAT’s Casey Ross reports this is the second attempt by California Assemblyman Rob Bonta to pass such a bill. The last version would’ve paid these out-of-network physicians 100 percent of the Medicare reimbursement for these services, which has been increased to 125 percent in the current proposal. That’s still not good enough, according to some doctors.

“Access to care will suffer,” said acute care surgeon Eileen Natuzzi, MD. “If my fees are capped or some of my associates fees are capped and it’s not [financially] feasible, then the number of surgeons and specialists available will decrease.”

Independent physicians argue the legislation would only encourage insurers to further narrow their networks, but Bonta said the bill would allow doctors to appeal payments to an independent panel if they’re unsatisfied.

“We’re creating a reasonable, practical approach to ensure that (physicians) get a minimum reimbursement that is a strong starting point,” Bonta said.

New York and Florida have already enacted similar laws. For more on the battle between physicians and insurers over the California bill, click on the link below: