November 2017

Recent legislation passed by the state of California known as California Assembly Bill 72 goes into effect July 1, 2017.

CA AB 72 requires the following changes:

AB72 applies to you if you receive services from an In-Network Facility where you receive non-emergency services by an Out-of-Network professional. This new state law protects you. You will pay no more than the same cost sharing that you would pay for those same non-Emergency Covered Services received from an In-Network professional.

This new state law provides great consumer protection against a long time practice known as “balance billing”.  These non-contracted professionals used to bill us the difference between our health plans contracted amounts and what they choose to charge for a specific procedure.  You are protected against this now. You will only owe the In-Network cost sharing amounts for such non-Emergency services.

Disclaimer: This is not intended to be legal advice or opinion.  You should should consult the specifics of your healthcare plan directly or review your specific plan’s Evidence of Coverage (EOC) or Summary of Benefits Description.  These sources will verify your cost share amount when accessing healthcare.