California Court Prohibits Balance Billing
The California Supreme Court recently ruled in Prospect Medical Group, Inc., et al. v. Northridge Emergency Medical Group, et al. that physicians are prohibited from balance billing HMO patients for emergency services. Physicians are entitled to a reasonable payment for their services and an HMO is obligated to make that payment. However, interpreting the statutory scheme as a whole, an HMO patient “may not be injected into the dispute.” Billing disputes over emergency medical care must be resolved solely between the physician and HMO.
The California Society of Anesthesiologists continues to take a leading role within the medical community in response to the issue of balance billing.
California Supreme Court opinion