September 13 hearing on proposed DMHC regulations - please attend if you can

CAL/AAEM News Service calaaem_news at yahoo.com
Sat Sep 9 10:53:43 PDT 2006


To CAL/AAEM Members, especially those of you in the LA area:

Attached you will find CMA's notice enlisting attendance at the DMHC's hearing on the new
regulations against balance billing, initiating a new dispute process, and reducing the
standards for fair payment. If you can, please attend this hearing, and let the CMA know
(see the notice) that you will be coming. 

You should have the opportunity to speak at this hearing for 5 minutes or so. I would
suggest talking about one of two of the following issues if they are applicable to your
practice, especially if you have any data to share:

Especially helpful would be examples of claims where you worked really hard to care for
someone and the health plan or IPA grossly underpaid the claim.

We are suggesting that you concentrate on caring for patients and not proclaiming the
'divine right to bill patients'.

Other issues you might testify about include:

    Why you think your charges are reasonable 

    Why payment at Medicare rates for contracted ER services is unreasonable 

    How you have been coerced into accepting below market rates for your services by your
hospital and the local IPA or Medical Group or plan Myths about emergency care provider
charges 

    The overhead you have in your practice 

    The issues that restrain your emergency care provider charges, i.e. if you staffing
contract allows the hospital to approve your charges 

    How your charges to other physician charges 

    What the impact of undermining emergency care provider collections and contract rates
would have on your departments staffing, coverage, wait times, ambulance diversions,
on-call specialty coverage provider services, etc

Examples of the emergency care safety net being in critical condition Why the uninsured
ARE the health insurance industry's problem, too Your experience with underpayment of
your claims, and with the DMHC complaint process

Whether you might leave or retire early if the regs are enacted and your income falls
significantly, etc.

We would really like to have as many docs as possible show up for this hearing. Please
attend if you can.

For those of you who live in N. California, there will be another hearing in Sacramento
on October 4, details to follow soon.

Myles Riner, MD, President, CAL/ACEP

Steven C.Gabaeff, M.D., President CalAAEM

Cyrus Shahpar & Brian Potts 
Managing Editors, CAL/AAEM News Service
University of California, Irvine

The CAL/AAEM Archives are available at: http://maillists.uci.edu/mailman/public/calaaem/


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