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Supporters Revive Proposal To Limit 'Surprise Medical Bills'


An effort to do away with “surprise medical bills” narrowly failed in the California Legislature last year, but patient and consumer advocates think they can resurrect it this year.

Patients receive these bills when they go to a hospital in their insurance network but receive care from a doctor outside of it — for instance, when an out-of-network radiologist reviews an MRI.

Legislation that would charge patients in-network costs in those situations fell three votes shy of reaching the governor’s desk last year.

Anthony Wright of the advocacy group Health Access says backers, which include unions, consumer groups and insurers, will again petition lawmakers.

"Because of legislative inaction last year, thousands of Californians have continued to get these surprise medical bills," Wright says. "Now they can see if their legislator was the reason they were getting that bill."

The California Labor Federation announced Monday it will actively campaign for the measure this year.

Physician groups oppose the bill because it would cause doctors to be reimbursed at Medicare rates.

"It essentially cuts physician compensation by two-thirds," says Janus Norman of the California Medical Association. "It essentially is telling providers there is no need for the health plan to contract with you."

Norman says that would mean fewer in-network physicians, limiting patients’ choices and access.

Analysis by the California Health Benefits Review Program also finds doctors would be paid less if the bill becomes law. But the report says it’s unlikely that would decrease the number of doctors available to perform services.