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.
 

Related News Articles

Headline
House Energy and Commerce Committee leaders today released a discussion draft of bipartisan legislation to address surprise medical bills.
Headline
President Trump today released guiding principles for addressing surprise medical bills.
Headline
The House Education and Labor Subcommittee on Health, Employment, Labor and Pensions today held a hearing on protecting patients from surprise medical bills.
Headline
The USC-Brookings Schaeffer Initiative for Health Policy today convened a panel of policymakers and stakeholders, including the AHA, to discuss its newly…
Headline
Seventeen health insurance, employer and consumer organizations today proposed recommendations for federal action to protect patients from surprise medical…
Headline
Legislative proposals for a Medicare public option could negatively affect patient access to care and significantly reduce payments to hospitals, AHA Executive…