Balance-billing proposal prompted by Zuckerberg hospital clears legislative obstacle

California legislation to protect patients from receiving unexpected out-of-network bills after visiting a hospital emergency room is moving forward, according to a San Francisco Chronicle report.

Lawmakers in the state assembly approved the bill May 30, and it now moves to the state Senate.

The bill prohibits balance billing. This refers to the practice of billing a patient for the difference between what the patient's insurance company decides to pay and the total cost of care.

Under the bill, patients would only be responsible for their copays and deductibles, even at a facility that is not in their insurance company’s network, according to the Chronicle. The bill also includes a process to resolve billing disputes between hospitals and insurers.

The bill comes after input from patient Nicki Pogue, who visited the emergency room at Zuckerberg San Francisco General Hospital with bronchitis and ended up with a large bill, according to a Public News Service report.

Zuckerberg hospital recently updated its billing practices after making headlines about  its policies. The hospital — which is San Francisco's largest public hospital and houses a level 1 trauma center — revealed in April that it will not resume balance billing.

 

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