Big consumer victory today. The California Supreme Court ruled 7-0 to protect patients from unfair bills during disputes between insurers and providers.
This unanimous ruling by California Supreme Court in Prospect Medical Group vs. Northridge Medical Center, is clear and unequivocal.
The case states directly, that when there’s a billing dispute between an emergency room doctors and an HMO, “a patient who is a member of an HMO may not be injected into the dispute. Emergency room doctors may not bill the patient for the disputed amount.”
After years of contentious fights through legislation and regulations, this is big news. As Health Access California has always contended, insured consumers should not have their credit and financial future ruined by unfair double billing. This ruling will prevent patients from being held hostage in a billing war between doctors and health plans. We appreciate the court’s decisive ruling to protect premium-paying patients from being unfairly billed and sent to collections and worse.