Balancing act…

Well, it’s not a balanced budget deal, but there’s some progress on balance billing.

Yesterday, the Department of Managed Health Care (DMHC) issued regulations to the Office of Administrative Law on the contentious issue of “balance billing.” The new regulations would restrict the practice of emergency health providers sending the bill to *insured* patients if they are having a dispute with their insurer. The OAL will provide a legal review of the regulations before putting them in full effect.

The patient–and their credit rating and financial future–should not be used as a pawn in these reimbursment disputes between insurers and providers. The regulations restrict this “balance billing” by making it an unfair billing practice, thus allowing DMHC enforcement actions against those providers who engage in activities that unfairly burden consumers.

It’s a good step. There is also pending legislation, by Sen. Pres. Perata, Assemblywoman Salas, and others, that would go broader, and look to help resolve these disputes between providers and insurers in the first place. But the first principle is to do no harm–to the patient, or their pocketbook.

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