California will likely soon join the growing list of states that have banned "surprise" medical bills to consumers, as often discussed here. Governor Jerry Brown is expected to sign AB-72, which the state legislature passed in late August, by the end of this month.
The common scenario that the bill targets is where an insured receives covered healthcare services from an in-network hospital, surgery center, imaging center or laboratory, while an out-of-network healthcare provider also provides services to the patient at the facility. Like other states' laws, the bill would limit the patient's financial obligation to the out-of-network provider to the amount that would have been owed had the provider been in-network.
AB-72 also requires that a patient be notified in advance of potential charges and give consent before the out-of-network provider provides services, and that insurers maintain adequate provider networks. Additionally, the bill would establish an independent dispute resolution process to resolve claim disputes between health insurance plans and out-of-network providers.
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