A California law that limits the size of bills from out-of-network physicians for care delivered in hospitals has changed the negotiation dynamics between hospital-based physicians and payers, giving payers an incentive to lower or cancel contracts with rates higher than their average, according to a new RAND Corporation study. Under the 2017 law, patients pay only their in-network cost-sharing obligation, and insurance plans pay the out-of-network professionals the greater of the payer's local average contracted rate or 125% of Medicare's fee-for-service rate.
 

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Surprise billing has no place in health care and America’s hospitals and health systems are committed to protecting patients from this unfair practice.