August 05, 2019
Area(s) of Interest: Payor Issues and Reimbursement Advocacy Out of Network Billing
The California Medical Association (CMA) is urging physicians to contact their members of Congress during the August recess about the surprise medical billing legislation moving swiftly through Congress.
Several of the bills moving through Congress mirror California’s unsuccessful surprise billing law (AB 72). While California protected patients from surprise medical bills, the rest of the law is not working. Insurers across the state are cancelling long-standing contracts with physician groups or imposing significant 25-45% payment cuts. Insurers have decided they no longer need to contract because they can just pay the low rate established in state law.
Physician networks are diminishing and access to care is in jeopardy for in-network care, as well as for emergency physicians and on-call surgeons, anesthesiologists and other specialists who care for patients in emergencies. If the on-call physicians no longer have a contract and will only be paid the low rate in the law, they cannot afford to accept call responsibilities. The Department of Managed Health Care has reported a 48% increase in patient access to care complaints since the passage of AB 72.
CMA and all of organized medicine are urging Congress to support H.R. 3502, the “Protecting People from Surprise Medical Bills Act,” authored by physician Congressmen Raul Ruiz, M.D., (D-CA) and Phil Roe, M.D., (R-TN), which is based on the proven, successful New York model.
Click here to access the American Medical Association Physicians Grassroots Network to send a message to your members of Congress. Tell them to:
- Protect patients from surprise medical bills.
- Establish a fair process that incentivizes insurers and physicians to contract, with a dispute resolution process that uses a reasonable market-based payment benchmark.
- Preserve patient access to in-network physicians, emergency physicians and on-call physician specialists who care for patients in emergencies.
- Cosponsor Ruiz-Roe H.R. 3502 “Protecting People from Surprise Medical Bills,” based on the proven New York model.
For more information:
CMA Surprise Billing Talking Points
CMA Letter to Congress Re: Surprise Billing