Hearing Addresses ED Charges
The Department of Managed Health Care on Monday held a hearing in San Diego to discuss "balance billing," a practice in which emergency department physicians bill patients the difference between charges for health care services and what the patients' managed care companies pay, the San Diego Union-Tribune reports. The agency held a hearing on the regulations last week in Burbank and will hold a third hearing in Sacramento on Monday.
Gov. Arnold Schwarzenegger (R) in July directed the agency to draft new rules to ban the practice.
Some doctors say that balance billing helps them ensure fair payment from insurers and that it will be more difficult for hospitals to arrange for doctors to provide ED services.
Doctors have called for state regulators to develop an independent arbitration system in which physicians and insurers could resolve disputes over payments and charges.
Theodore Mazer, president of the San Diego County Medical Society, said doctors would like the arbitration system to be implemented on a trial basis for a few years to assess its fairness.
A draft of the regulations calls for a "dispute resolution mechanism," but it does not specify what form the mechanism would take. Final versions of the regulations are expected later this year (Darcé, San Diego Union-Tribune, 9/26).