SACRAMENTO >> Consumers in California will receive more protection from surprise medical bills under a new law that took effect July 1. The lead author, Assemblymember Rob Bonta (D-Oakland), says AB 72 makes California home to the nation’s strongest consumer protections.
“This was clearly a huge problem that has now been solved for families across California,” Bonta said. “This law marks a milestone for California consumers. When patients do everything correctly by staying within their health networks when they seek medical care, they shouldn’t get hit with a surprise bill that is often in the hundreds or thousands of dollars.”
A recent study by Yale University found 22 percent of visits to emergency rooms resulted in surprise medical bills. A separate survey by Consumer Reports found 30 percent of patients had reported receiving a surprise medical bill.
AB 72 requires the health plan and health insurer to reimburse non-contracting individual healthcare providers at an amount that is the greater of the average contracted rate or 125 percent of the Medicare reimburses rate.
Prior to AB 72, when a patient underwent a medical procedure and did everything right to keep costs down by going to an in-network facility, he or she could still unwittingly receive care from an out-of-network physician, who subsequently could bill them directly for costs the insurance company wouldn’t cover.
“This law shows how Californians win when insurance companies and doctors work together and put patients first. We’ve created the strongest consumer protection law in the nation and solved a problem that this legislature had struggled with for years,” said Bonta.
AB 72 was co-sponsored by the California Labor Federation and Health Access California.
“Even with all the uncertainty about health care coming out of Washington, Sacramento is providing some more security for patients, who should now no longer get surprise out-of-network bills when they go to an in-network hospital or other facility. California has now become the state with the strongest protections in the nation against surprise bills, benefiting millions of consumers,” said Anthony Wright, executive director, Health Access California, and co-sponsor of last year’s AB 72 with the California Labor Federation. “This landmark law to protect patients from financial calamity is the result of many Californians telling their story of being saddled with surprise medical bills of thousands of dollars.”
Governor Jerry Brown signed AB 72 on September 23, 2016.
