The California state legislature is considering a bill that would prohibit hospitals in the Golden State from charging an individual more than his or her co-payment or deductible, regardless of whether the hospital was in the patient’s insurance network or not.
The objective of the bill is to end the practice of what is known as “balance billing,” where a patient receives a bill when visiting a hospital or emergency room that is out of the patient’s network. In some cases, where an individual is unconscious or in some other type of emergency, he or she may not be able to make it to a hospital that is part of his or her insurance network. That has led to instances where patients have received bills for tens or hundreds of thousands of dollars.
Proposed a member of the state Assembly and a state Senator, the bill would hold patients liable for whatever their co-payment or insurance deductible is and hospitals would be prohibited from pursuing additional charges, regardless of whether the facility was part of the patient’s insurance network or not, and it would regulate prices on procedures and treatment to 150% of whichever is greater between the average contracted rate in the area of the price that Medicare charges.
“Patients would no longer receive exorbitant, surprise bills,” Assemblyman David Chiu, according to a published report. “The discussion between insurers and hospitals would become far more predictable.”
A number of other states, including Colorado and New Mexico, have also proposed legislation that would end balance billing.
