California patients will enjoy strong new protection from surprise out-of-network medical bills under bipartisan legislation co-authored by Assemblyman Brian Dahle and signed into law by the Governor on Friday.
Assembly Bill 72 bars ‘surprise billing’ by doctors who are out of a patient’s insurance network, even though they practice at an in-network hospital. This can cost unsuspecting patients thousands of dollars out of their own pocket despite their good-faith efforts to seek treatment by providers in their insurance company’s network.
For instance, a patient might choose an in-network surgeon and schedule a procedure at an in-network hospital, only to learn after the fact that she was treated by an out-of-network anesthesiologist or other specialist — sometimes while the patient wasn’t even conscious or able to make a choice. With insurance companies increasingly steering patients into narrow networks of providers, this protection is all the more important.
“Patients can’t be expected to check the network status of every doctor while they are so sick or badly injured that they are in the hospital,” Dahle said. “This is a basic patient protection that is long overdue. California has built a model here that I fully expect to see copied nationwide.”
Assemblyman Dahle was a lead author of AB 72 along with fellow Republican Assemblyman Brian Maienschein, from San Diego County, and Democratic Assemblymembers including Jim Wood (D-Healdsburg) and Rob Bonta (D-Oakland).
“I certainly don’t always see eye to eye with the majority party in Sacramento,” Dahle said, “but I am very proud that we were able to work across party lines over the past two years to negotiate the difficult details of this legislation.”
When patients are treated by out-of-network doctors at in-network hospitals, AB 72 sets a cap on the charges, based on the average contracted insurance rate.
Separately, the Governor also signed into law a measure to help rural hospitals recruit physicians.
Assembly Bill 2024, by Assemblyman Wood and co-authored by Dahle, allows critical-access hospitals, which serve remote areas including most of the 1st Assembly District, to directly hire and employ doctors. California currently has the strictest limits on “corporate practice of medicine” in the United States. When doctors must establish independent practices, it is especially difficult to attract physicians — especially those graduating with large medical-school debts — to rural areas. Small hospitals have long urged the Legislature to relax the rules to ease the shortage of medical providers serving rural California.
“This is an important tool to ensure that residents of small communities actually have a local doctor,” Dahle said.
Brian Dahle, R-Bieber, represents California’s 1st Assembly District, which includes Lassen County along with all or parts of Butte, Modoc, Nevada, Placer, Plumas, Shasta, Sierra and Siskiyou counties.
