Compromise legislation seeking to limit out-of-network medical bills sailed from the Assembly to Gov. Jerry Brown on Wednesday.
A bill seeking to limit such charges, typically incurred when an insured patient gets treated by a specialist not in his or her network, collapsed last year in the face of fierce opposition from the California Medical Association. The doctors’ lobby warned that measure would backfire and lead to a fewer doctors being available. Organized labor had championed the bill.
One year later an amended version, Assembly Bill 72 by Assemblyman Rob Bonta, D-Alameda, passed on a bipartisan 70-0 vote. The California Medical Association adopted a neutral stance after amendments gave more options for the level at which out-of-network physicians are reimbursed and fleshed out the process to dispute charges.
For patients, AB 72 would mean paying only the rate for an in-network doctor as long as the patient went to an in-network hospital. Insurance companies would have to pay doctors the rest, and the bill allows an independent process for doctors to challenge that payment.
Both Republicans and Democrats praised what they called a worthy solution to a stubbornly persistent issue.
“This has been a problem that has plagued consumers...and, frankly, this building for decades,” said Assemblyman Brian Maienschein, R-San Diego.