11 ms·

California lawmakers introduce plan to end surprise ER bills

121 points by howard941 8y ago

mc32 8y ago
And that happened to people with private insurance (SF General was “out of network” for the two examples.) But upwards of $20 thousand for very simple things is outrageous, This has to become a national effort to curb these exploitative and unfair billing practices. It’s simply outrageous.
- jdavis703 8y ago
  San Francisco General Hospital is focused on serving the public, i.e. those without private health insurances. Per Wikipedia: About 80 percent of its patient population either receives publicly funded health insurance (Medicare or Medi-Cal) or is uninsured. SFGH also cares for the homeless, who make up about 8 percent of its patients. They effectively use the high rates for privately insured folks to subsidize their public mission. Of course this all speaks to a really broken health care system, but it's not like uninsured people would have been charged even more than $20k.
  - mc32 8y ago
    This the Robbin Hood approach to a problem. How on Earth does a public hospital think it’s ethical to exploit people like this and think it’s okay to do because I’m helping someone else?
    - gowld 8y ago
      It's price discrimination and it's how most businesses operate because that's the only viable option in many industries.
      - r00fus 8y ago
        It’s only a viability issue because everyone does it. Regulation can help here.
    - pkaye 8y ago
      What other options does the public hospital have?
      - shhehebehdh 8y ago
        Ummm taxes.
        pkaye 8y ago
        But that is not under control of the hospital. The lawmakers need to enact it.
  - fmajid 8y ago
    That argument would hold water if they didn't also receive nearly a billion a year in funding from the City of San Francisco.
  - dmckeon 8y ago
    (Z)SFGH is also the only Level I trauma center in SF City/County and San Mateo County (415 and 650 area codes) (note: trauma patients in the southern part of SM county are taken to Stanford Hospital). So, under their billing practices, if you suffer major trauma, say in a vehicle collision, and are taken to SFGH, you may win multiple lotteries: major injury, recovery time, major medical bills to pay, and the chance to pay some other people’s medical bills as well, depending on the hospital policy, and whether you have an HMO or PPO (details are complicated.) The thing that most US Americans stumble over here is their general expectation that goods and services have a price, and that bargaining for a better price is not an option. We do not expect to bargain over groceries in a supermarket, or gasoline when fueling, or most other goods. In a professional setting, like a medical office, trying to negotiate a price seem inappropriate. But behind the scenes, a vast network of third parties are negotiating on behalf of other patients, and the uninformed or naive consumer not only pays “retail” but is asked to pay a wildly inflated price that all the third parties know is merely an initial offer.
    - masonic 8y ago
      (415 and 650 area codes) Much of 650's population is in Santa Clara County (Mtn. View, Palo Alto, parts of Sunnyvale)
thorwasdfasdf 8y ago
Finally, we see legislators doing something good for a change: "“These practices are outrageous,” says Chiu(Assembly member David Chiu) , who represents part of San Francisco in the Assembly. “No one who is going through the trauma of emergency room care should be subsequently victimized by outrageous hospital bills.” So, they introduce a bill that will reduce patient billing abuse in CA. Based on the article, it seems like Zuckerberg Hospital was especially egregious in abusing it's patients with billing. I hope they can continue to crack down on Hospital overbiling.
- gumby 8y ago
  > Finally, we see legislators doing something good for a change: Come on, we don't need this invective. Sure, I can find a reason to be outraged every day by some legislative decision someplace but in the main, we still have roads, air traffic control, health and safety rules etc.
- deleted 8y ago
  [deleted]
dsfyu404ed 8y ago
Preventing attempts at collections (like this law does), insurance reform, "medicare for all", etc, etc. are nice but they don't address the root problem. Costs are out of control. Until we find a way to control costs we will still pay way too much. All that changes until then is who pays what amounts and the point at which payment is made. The hospitals are just going to shuffle around who pays what in order to make up for the income they're not getting from surprise bills unless there's something (actual competition, a government payer who won't put up with that crap, etc,) to stop them. Sure this is a step in a good direction but there's only so many band-aids you can apply to a gunshot wound. While unscrupulous practices like this bill takes aim at should be weeded out it strikes me as hopeless in light of the bigger picture.
- howard941 8y ago
  Do you have any cost control ideas?
  - thorwasdfasdf 8y ago
    Set reasonable low Price ceilings on procedures/ per night stays, pills, etc, adjusted on location and make the hospital liable for any costs above those. I don't see why a night in the hospital should cost 8000$ per night or why a pill should cost 100$, or a little ambulance ride should be 2800$ etc.
- nradov 8y ago
  Yes the systemic cost is the real problem. As our population becomes older, more obese, and more sedentary the costs will keep increasing. Ultimately I think we're going to need some combination of legislated cost controls and care rationing based on QALYs. Otherwise healthcare will collapse the entire economy. This will all be hugely unpopular.
- zaroth 8y ago
  The problem is two-sided. Yes the costs paid by the hospital, and the cost of the techniques and tools used by the hospital are all too high, because the system does not properly incentivize finding lower cost solutions that may be equally effective and safe. In this case the problem is exacerbated by the way that privately insured patients are being exploited to subsidize publicly insured patients; “A hospital spokesperson initially told Vox that the hospital’s focus is on serving those with public health coverage, even if that means offsetting those costs with high bills for the privately insured.” It should be illegal to charge two different people different prices for the same procedure at the same hospital. At a more granular level, it should be illegal to price discriminate on anything that can be itemized. The middle and upper class patients are exploited to pay for publically insured patients who get service below cost which the hospital can’t legally turn away.
lykr0n 8y ago
Second, the bill would regulate the prices that the hospital could charge for its care, limiting the fees to 150 percent of the Medicare price or the average contracted rate in the area, whichever is greater. Seems like this will start to solve the chicken and egg problem. Hospitals charge more because insurance will pay more. Insurance costs more because hospitals charge more.
- gowld 8y ago
  "150%" smells like a made-up number. Unless providers have some freedom to raise Medicare prices (which they don't), this effectively means that Medicare sets prices for everything. I'd rather see laws that strengthen consumers control over their insurance options (improving the power of the demand side of the market), including price disclosures, than pushing the rope from the back end without any competitive market forces influencing prices.
  - batbomb 8y ago
    Of course it's arbitrary but that doesn't mean it's not reasonable. Sure - they might be close to breaking even or at a slight loss when taking medicare, and that probably gives them the wiggle room they need to be sustainable. Put another way - the government gets a 33% discount compared to private insurers. If the argument is that medicare prices are unreasonably low, that seems like a different issue.
  - heydenberk 8y ago
    Have you ever tried to be a conscious consumer for health care? How about for serious health care for a life-threatening of life-changing issue like cancer or childbirth? I never understood the desire to offload any of this cognitive load to the consumer, many of whom are going through the most difficult times of their lives.
    - lewis500 8y ago
      The weird thing is that, even though a lot of policy is oriented toward making you a conscious consumer (high deductibles, coinsurance) in many cases you just can’t do it,at least not very well. My wife got an allergy test at a local allergy clinic, but she had 20% coinsurance so we tried to figure out how much it would cost. Everyone there treated us like garbage. Even when we called the billing department in advance they told us there was no way to know in advance how much the basic allergy test would cost until she saw the doctor. So we went to the clinic (stupidly), and the nurses just acted like we were crazy. Finally one did tell us what the bill would be:$12k. I had researched these tests online and was floored; that’s way more expensive than it should be, and the doctor who gave her a referral had told us it would be a reasonable price. So we were in the awkward position of just leaving the appointment. The doctor then basically talked to us somberly like we were the poorest people on earth, and said “listen, most of the test is for allergens that don’t exist in northern California.” If I just give u the local ones it’ll be like $1800.” I started laughing. Later on I read an NPR story about a lady who had a$48k allergy test from there. Just a complete scam, much worse than a car dealer because at least there they will tell you a price and they will not sell you ten extra useless cars evenif you don’t explicitly say “don’t give me ten superfluous cars for no reason.” Anyway, we got the limited test, and at the end the doctor said “listen I’m not supposed to do this, but given the financial hardship I’ll make an exception. If I don’t put the results in the system you’ll only be charged for the visit.” And he just wrote the results on a yellow notepad paper and tore it out for us. Tldr we were treated like annoying busybodies for asking the price at an in-network facility, and then treated like indigents when we balked at paying way more than anywhere else charges, for totally bs procedures.
geebee 8y ago
I spent a night once in the ER for observation. I never got anything but Tylenol, though I think the concern that led to the overnight stay was reasonable. The bill was $16,000. This was certainly a defensive, risk-averse treatment, but I think it was a reasonable decision. I think my insurance paid about 8,000. The magic words on the bill were "Patient is nor responsible for the difference between the amount paid by insurance and amount billed". This is because I went to an in-network hospital with a contract. I talked about this with some of my physician friends, and they told me this is typical. In fact, the original bill doesn't represent what they expect to be paid. It represents an extreme position taken to start negotiations with an HMO or other insurance company. Here's the trap: if you don't have insurance, you are not just hit with the high bill that represents what the hospital would pay an HMO, you're hit with he wildly inflated bill they send to an HMO in anticipation of being paid much less. So if you don't have insurance in the US, you're doubly hosed. I know I'm supposed to hate my HMO and all, but to me, this is a bit like belonging to a union. As part of a powerful group, I have someone not just paying the bill but knocking it down for me. I may not like being part of a group plan, but on my own, I'm toast. Unfortunately, this story shows that you can still end up on the wrong side of this billing practice even if you do have insurance, because some hospitals remain out of network for all insurance, and if you're incapacitated or simply don't have the plan in front of you and a couple hours to research the billing practices of various hospitals as your head is bleeding and you're being taken to the ER, you can end up in a similar situation to an uninsured person. It turns out that it may in fact be impossible to insure yourself against ruinous bills. Nicely done, there.
- gowld 8y ago
  If you don't have insurance you can negotiate your bill. The problem is that people don't understand that, that Americans hate negotiating, and that negotiating the price of something after you bought it (or even after you need it) stinks.
  - maxxxxx 8y ago
    People also don't know how far they can negotiate. For a lot of people these numbers are close to financial ruin so it's hard to negotiate with clear head. Add to that being sick. It's a perverse, heartless system.
admax88q 8y ago
Negotiating the cost of life saving treatment, checking in-network vs out-network, vs in-network with contract, shopping for different insurance providers. The amount of mental energy that Americans spend on health care just seems absolutely nuts to me. How much productivity does your country lose because people have to spend time even thinking about things like this?
- andrepd 8y ago
  It's beyond ridiculous that the richest country in human history cannot even ensure health treatment to its citizens, when countries with 1/20 of its GDP/capita manage that. Goes to show that "economic growth" by itself means nothing, if it does not even translate into something so basic as health care.
  - sorenn111 8y ago
    which country has universal healthcare with 1/20th of US GDP per capita? genuinely curious
    - HarryHirsch 8y ago
      I think he's talking about Cuba.
      - NoGravitas 8y ago
        Most likely. Cuba's kind of an outlier in having an extraordinarily good medical system relative to its GDP, but it's proof at least that, given political will, it's possible. https://en.wikipedia.org/wiki/Healthcare_in_Cuba https://en.wikipedia.org/wiki/Healthcare_in_Cuba
      - andrepd 8y ago
        Cuba is indeed a good example, but there are others. Ghana for example (actually 1/30th of the GDP/capita).
  - deleted 8y ago
Animats 8y ago
Some years back, the California legislature passed a bill which limited what hospitals could charge uninsured patients to the Medicare reimbursement rates. Schwarzenegger vetoed it.
- masonic 8y ago
  CA has been under single-party control since then. What's the barrier since then?
BrainInAJar 8y ago
What about just eliminating medical bills entirely?
sivanmz 8y ago
These laws don't apply to employees covered by employer self-funded plans, which are predominant. California can't enforce them in most cases.
fmajid 8y ago
I kinda feel bad for Mark Zuckerberg. He donated a massive amount of money to the city-run hospital in a bid to improve his image (like Mark Benioff did with the state-run UCSF Children's Hospital), and it turns out they are even more rapacious than him and now his name is being dragged further in the mud thanks to them. This incident does illustrate how corrupt health care is in the US, and public institutions are just bad as private ones.
- heavenlyblue 8y ago
  Well, or he could have done some research before donating that money.
sivanmz 8y ago
California protections against balance/surprise medical billing are not enforceable when an employee is covered by a "self-insured" or "self-funded" employer plan. California doesn't regulate that plan, and also cannot intervene in the billing between the provider, patient and insurance. Most medium to large employers are using such plans which means that employees are not protected from such billing. http://www.insurance.ca.gov/01-consumers/110-health/60-resources/upload/AB-72-Fact-Sheet-Consumer_Protection_for_Surprise_Medical_Bills-rev2.pdf http://www.insurance.ca.gov/01-consumers/110-health/60-resou... "Does the New Law Apply to Everyone? The new law applies to people with health insurance policies or plans regulated by the California Department of Insurance or the California Department Managed Health Care that were issued, amended, or renewed on or after July 1, 2017. It does not apply to Medi-Cal plans, Medicare plans or “self-insured plans.”"

121 points by howard941 8y ago

mc32 8y ago

And that happened to people with private insurance (SF General was “out of network” for the two examples.) But upwards of $20 thousand for very simple things is outrageous, This has to become a national effort to curb these exploitative and unfair billing practices. It’s simply outrageous.

jdavis703 8y ago
San Francisco General Hospital is focused on serving the public, i.e. those without private health insurances. Per Wikipedia: About 80 percent of its patient population either receives publicly funded health insurance (Medicare or Medi-Cal) or is uninsured. SFGH also cares for the homeless, who make up about 8 percent of its patients. They effectively use the high rates for privately insured folks to subsidize their public mission. Of course this all speaks to a really broken health care system, but it's not like uninsured people would have been charged even more than $20k.
- mc32 8y ago
  This the Robbin Hood approach to a problem. How on Earth does a public hospital think it’s ethical to exploit people like this and think it’s okay to do because I’m helping someone else?
  - gowld 8y ago
    It's price discrimination and it's how most businesses operate because that's the only viable option in many industries.
    - r00fus 8y ago
      It’s only a viability issue because everyone does it. Regulation can help here.
  - pkaye 8y ago
    What other options does the public hospital have?
    - shhehebehdh 8y ago
      Ummm taxes.
      - pkaye 8y ago
        But that is not under control of the hospital. The lawmakers need to enact it.
- fmajid 8y ago
  That argument would hold water if they didn't also receive nearly a billion a year in funding from the City of San Francisco.
- dmckeon 8y ago
  (Z)SFGH is also the only Level I trauma center in SF City/County and San Mateo County (415 and 650 area codes) (note: trauma patients in the southern part of SM county are taken to Stanford Hospital). So, under their billing practices, if you suffer major trauma, say in a vehicle collision, and are taken to SFGH, you may win multiple lotteries: major injury, recovery time, major medical bills to pay, and the chance to pay some other people’s medical bills as well, depending on the hospital policy, and whether you have an HMO or PPO (details are complicated.) The thing that most US Americans stumble over here is their general expectation that goods and services have a price, and that bargaining for a better price is not an option. We do not expect to bargain over groceries in a supermarket, or gasoline when fueling, or most other goods. In a professional setting, like a medical office, trying to negotiate a price seem inappropriate. But behind the scenes, a vast network of third parties are negotiating on behalf of other patients, and the uninformed or naive consumer not only pays “retail” but is asked to pay a wildly inflated price that all the third parties know is merely an initial offer.
  - masonic 8y ago
    (415 and 650 area codes) Much of 650's population is in Santa Clara County (Mtn. View, Palo Alto, parts of Sunnyvale)

thorwasdfasdf 8y ago

Finally, we see legislators doing something good for a change: "“These practices are outrageous,” says Chiu(Assembly member David Chiu) , who represents part of San Francisco in the Assembly. “No one who is going through the trauma of emergency room care should be subsequently victimized by outrageous hospital bills.” So, they introduce a bill that will reduce patient billing abuse in CA. Based on the article, it seems like Zuckerberg Hospital was especially egregious in abusing it's patients with billing. I hope they can continue to crack down on Hospital overbiling.

gumby 8y ago
> Finally, we see legislators doing something good for a change: Come on, we don't need this invective. Sure, I can find a reason to be outraged every day by some legislative decision someplace but in the main, we still have roads, air traffic control, health and safety rules etc.
deleted 8y ago
[deleted]

dsfyu404ed 8y ago

Preventing attempts at collections (like this law does), insurance reform, "medicare for all", etc, etc. are nice but they don't address the root problem. Costs are out of control. Until we find a way to control costs we will still pay way too much. All that changes until then is who pays what amounts and the point at which payment is made. The hospitals are just going to shuffle around who pays what in order to make up for the income they're not getting from surprise bills unless there's something (actual competition, a government payer who won't put up with that crap, etc,) to stop them. Sure this is a step in a good direction but there's only so many band-aids you can apply to a gunshot wound. While unscrupulous practices like this bill takes aim at should be weeded out it strikes me as hopeless in light of the bigger picture.

howard941 8y ago
Do you have any cost control ideas?
- thorwasdfasdf 8y ago
  Set reasonable low Price ceilings on procedures/ per night stays, pills, etc, adjusted on location and make the hospital liable for any costs above those. I don't see why a night in the hospital should cost 8000$ per night or why a pill should cost 100$, or a little ambulance ride should be 2800$ etc.
nradov 8y ago
Yes the systemic cost is the real problem. As our population becomes older, more obese, and more sedentary the costs will keep increasing. Ultimately I think we're going to need some combination of legislated cost controls and care rationing based on QALYs. Otherwise healthcare will collapse the entire economy. This will all be hugely unpopular.
zaroth 8y ago
The problem is two-sided. Yes the costs paid by the hospital, and the cost of the techniques and tools used by the hospital are all too high, because the system does not properly incentivize finding lower cost solutions that may be equally effective and safe. In this case the problem is exacerbated by the way that privately insured patients are being exploited to subsidize publicly insured patients; “A hospital spokesperson initially told Vox that the hospital’s focus is on serving those with public health coverage, even if that means offsetting those costs with high bills for the privately insured.” It should be illegal to charge two different people different prices for the same procedure at the same hospital. At a more granular level, it should be illegal to price discriminate on anything that can be itemized. The middle and upper class patients are exploited to pay for publically insured patients who get service below cost which the hospital can’t legally turn away.

lykr0n 8y ago

Second, the bill would regulate the prices that the hospital could charge for its care, limiting the fees to 150 percent of the Medicare price or the average contracted rate in the area, whichever is greater. Seems like this will start to solve the chicken and egg problem. Hospitals charge more because insurance will pay more. Insurance costs more because hospitals charge more.

gowld 8y ago
"150%" smells like a made-up number. Unless providers have some freedom to raise Medicare prices (which they don't), this effectively means that Medicare sets prices for everything. I'd rather see laws that strengthen consumers control over their insurance options (improving the power of the demand side of the market), including price disclosures, than pushing the rope from the back end without any competitive market forces influencing prices.
- batbomb 8y ago
  Of course it's arbitrary but that doesn't mean it's not reasonable. Sure - they might be close to breaking even or at a slight loss when taking medicare, and that probably gives them the wiggle room they need to be sustainable. Put another way - the government gets a 33% discount compared to private insurers. If the argument is that medicare prices are unreasonably low, that seems like a different issue.
- heydenberk 8y ago
  Have you ever tried to be a conscious consumer for health care? How about for serious health care for a life-threatening of life-changing issue like cancer or childbirth? I never understood the desire to offload any of this cognitive load to the consumer, many of whom are going through the most difficult times of their lives.
  - lewis500 8y ago
    The weird thing is that, even though a lot of policy is oriented toward making you a conscious consumer (high deductibles, coinsurance) in many cases you just can’t do it,at least not very well. My wife got an allergy test at a local allergy clinic, but she had 20% coinsurance so we tried to figure out how much it would cost. Everyone there treated us like garbage. Even when we called the billing department in advance they told us there was no way to know in advance how much the basic allergy test would cost until she saw the doctor. So we went to the clinic (stupidly), and the nurses just acted like we were crazy. Finally one did tell us what the bill would be:$12k. I had researched these tests online and was floored; that’s way more expensive than it should be, and the doctor who gave her a referral had told us it would be a reasonable price. So we were in the awkward position of just leaving the appointment. The doctor then basically talked to us somberly like we were the poorest people on earth, and said “listen, most of the test is for allergens that don’t exist in northern California.” If I just give u the local ones it’ll be like $1800.” I started laughing. Later on I read an NPR story about a lady who had a$48k allergy test from there. Just a complete scam, much worse than a car dealer because at least there they will tell you a price and they will not sell you ten extra useless cars evenif you don’t explicitly say “don’t give me ten superfluous cars for no reason.” Anyway, we got the limited test, and at the end the doctor said “listen I’m not supposed to do this, but given the financial hardship I’ll make an exception. If I don’t put the results in the system you’ll only be charged for the visit.” And he just wrote the results on a yellow notepad paper and tore it out for us. Tldr we were treated like annoying busybodies for asking the price at an in-network facility, and then treated like indigents when we balked at paying way more than anywhere else charges, for totally bs procedures.

geebee 8y ago

I spent a night once in the ER for observation. I never got anything but Tylenol, though I think the concern that led to the overnight stay was reasonable. The bill was $16,000. This was certainly a defensive, risk-averse treatment, but I think it was a reasonable decision. I think my insurance paid about 8,000. The magic words on the bill were "Patient is nor responsible for the difference between the amount paid by insurance and amount billed". This is because I went to an in-network hospital with a contract. I talked about this with some of my physician friends, and they told me this is typical. In fact, the original bill doesn't represent what they expect to be paid. It represents an extreme position taken to start negotiations with an HMO or other insurance company. Here's the trap: if you don't have insurance, you are not just hit with the high bill that represents what the hospital would pay an HMO, you're hit with he wildly inflated bill they send to an HMO in anticipation of being paid much less. So if you don't have insurance in the US, you're doubly hosed. I know I'm supposed to hate my HMO and all, but to me, this is a bit like belonging to a union. As part of a powerful group, I have someone not just paying the bill but knocking it down for me. I may not like being part of a group plan, but on my own, I'm toast. Unfortunately, this story shows that you can still end up on the wrong side of this billing practice even if you do have insurance, because some hospitals remain out of network for all insurance, and if you're incapacitated or simply don't have the plan in front of you and a couple hours to research the billing practices of various hospitals as your head is bleeding and you're being taken to the ER, you can end up in a similar situation to an uninsured person. It turns out that it may in fact be impossible to insure yourself against ruinous bills. Nicely done, there.

gowld 8y ago
If you don't have insurance you can negotiate your bill. The problem is that people don't understand that, that Americans hate negotiating, and that negotiating the price of something after you bought it (or even after you need it) stinks.
- maxxxxx 8y ago
  People also don't know how far they can negotiate. For a lot of people these numbers are close to financial ruin so it's hard to negotiate with clear head. Add to that being sick. It's a perverse, heartless system.

admax88q 8y ago

Negotiating the cost of life saving treatment, checking in-network vs out-network, vs in-network with contract, shopping for different insurance providers. The amount of mental energy that Americans spend on health care just seems absolutely nuts to me. How much productivity does your country lose because people have to spend time even thinking about things like this?

andrepd 8y ago
It's beyond ridiculous that the richest country in human history cannot even ensure health treatment to its citizens, when countries with 1/20 of its GDP/capita manage that. Goes to show that "economic growth" by itself means nothing, if it does not even translate into something so basic as health care.
- sorenn111 8y ago
  which country has universal healthcare with 1/20th of US GDP per capita? genuinely curious
  - HarryHirsch 8y ago
    I think he's talking about Cuba.
    - NoGravitas 8y ago
      Most likely. Cuba's kind of an outlier in having an extraordinarily good medical system relative to its GDP, but it's proof at least that, given political will, it's possible. https://en.wikipedia.org/wiki/Healthcare_in_Cuba https://en.wikipedia.org/wiki/Healthcare_in_Cuba
    - andrepd 8y ago
      Cuba is indeed a good example, but there are others. Ghana for example (actually 1/30th of the GDP/capita).
- deleted 8y ago

Animats 8y ago

Some years back, the California legislature passed a bill which limited what hospitals could charge uninsured patients to the Medicare reimbursement rates. Schwarzenegger vetoed it.

masonic 8y ago
CA has been under single-party control since then. What's the barrier since then?

BrainInAJar 8y ago

What about just eliminating medical bills entirely?

sivanmz 8y ago

These laws don't apply to employees covered by employer self-funded plans, which are predominant. California can't enforce them in most cases.

fmajid 8y ago

I kinda feel bad for Mark Zuckerberg. He donated a massive amount of money to the city-run hospital in a bid to improve his image (like Mark Benioff did with the state-run UCSF Children's Hospital), and it turns out they are even more rapacious than him and now his name is being dragged further in the mud thanks to them. This incident does illustrate how corrupt health care is in the US, and public institutions are just bad as private ones.

heavenlyblue 8y ago
Well, or he could have done some research before donating that money.

sivanmz 8y ago

California protections against balance/surprise medical billing are not enforceable when an employee is covered by a "self-insured" or "self-funded" employer plan. California doesn't regulate that plan, and also cannot intervene in the billing between the provider, patient and insurance. Most medium to large employers are using such plans which means that employees are not protected from such billing. http://www.insurance.ca.gov/01-consumers/110-health/60-resources/upload/AB-72-Fact-Sheet-Consumer_Protection_for_Surprise_Medical_Bills-rev2.pdf http://www.insurance.ca.gov/01-consumers/110-health/60-resou... "Does the New Law Apply to Everyone? The new law applies to people with health insurance policies or plans regulated by the California Department of Insurance or the California Department Managed Health Care that were issued, amended, or renewed on or after July 1, 2017. It does not apply to Medi-Cal plans, Medicare plans or “self-insured plans.”"