Sacramento – Today AB 72 by Assemblymembers Jim Wood (D-Healdsburg), Rob Bonta (D-Alameda), Susan Bonilla (D-Concord), Brian Maienschein (R-San Diego), Brian Dahle (R-Bieber), and Lorena Gonzalez (D-San Diego) was signed by the Governor. Beginning January 1, 2017, this law will protect patients from the unfair practice of receiving surprise bills for healthcare when it was provided, unknowingly to the patient, by providers outside their health plan’s network.
For nearly 40 years patients covered by a health plan have carefully sought care from only those doctors and hospitals that are in their network. “Unfortunately it is all too common that patients receive "surprise bills" for receiving services or care from providers or facilities that they did not know were not a part of their health plan network,” said Asm. Jim Wood. “These unexpected medical expenses have devastated families' finances and was just plain unfair.”
Patients will no longer be balance-billed and, as long as a patient is treated at an in-network facility, payment will be limited to the patient’s in-network share of cost – it will not matter that a particular provider was not in their network. Out-of-network doctors or other providers, such as labs, that operate at an in-network facility will be prohibited from billing patients any amount beyond the in-network rate. AB 72 sets up the reimbursement rates to these out-of-network providers at either the average contracted rate or 125% of the established Medicare amount, whichever is greater.
“As chair of the Assembly Health Committee,” said Wood, “I am so proud to have been part of this collaborative process, engaging legislators from both parties, patients, patient advocates, doctors, health plans, insurers, hospitals, professional health care associations, and many other stakeholders. AB 72 received unanimous, bipartisan support practice. The success of this legislation is a huge accomplishment and wonderful example of when there is a tough and complicated issue, strong leadership and bipartisan involvement can solve big problems.”
Thank you Governor Brown for signing AB 72! Let's keep tackling these tough issues together on behalf of our citizens.
Elected in 2014, Assemblymember Jim Wood (D- Healdsburg) represents the 2nd Assembly District, which includes all of Del Norte, Trinity, Humboldt and Mendocino counties, plus northern and coastal Sonoma County, including the northern half of Santa Rosa.