New out-of-network billing and payment law took effect July 1
On July 1, 2017, a new law (AB 72) took effect that changes the billing practices of non-participating physicians providing non-emergent care at in-network facilities including hospitals, ambulatory surgery centers and laboratories. The law, signed in 2016, was designed to reduce unexpected medical bills when patients go to an in-network facility but receive care from an out-of-network doctor.
CMA is aware of the potential adverse impacts of the new law on our physician members and have dedicated significant resources in order to achieve the best possible outcomes for physicians in light of the new billing restrictions.
Below are resources CMA has developed to help physicians navigate this new system.
- CMA FAQ: “A Physician’s Guide to AB 72: Questions and Answers”
- A Physician’s Guide to the AB 72 Independent Dispute Resolution Process
- Instructions and Sample Form for Obtaining Patient Consent Under California’s New Law on Billing and Payment for Out-of-Network Services at In-Network Facilities
- Sample Internal Appeal Letter for Interim Payment for Non-Emergency Services at an In-Network Facility
- Billing Requirements Under California’s New Law on Billing and Payment for Out-of-Network Services at In-Network Facilities
- AB 72 Payment Monitoring Workbook
- CMA On-Call Document #7508: “Non-Contracting Physicians”
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