Schwarzenegger Weighs Legislation on Insurer Payments to Doctors

[CAL/AAEM News Service]

Schwarzenegger Weighs Legislation on Insurer Payments to Doctors

Source: The California Healthline (http://www.californiahealthline.org )
Date: July 15, 2008


Gov. Arnold Schwarzenegger (R) is considering a bill (AB 1155) that would increase the state's power to fine health insurers who do not pay or underpay medical bills submitted by doctors, the Los Angeles Times reports. 

On Monday, the Assembly voted 45-24 to approve the measure by Assembly member Jared Huffman (D-San Rafael), and the Senate voted 24-11 to approve it last year.

For and Against
Richard Frankenstein, president of the California Medical Association, said that under the current rules, regulators often appear reluctant to challenge insurers. In addition, he said that the bill would force insurers to pay larger fines.

Insurers and state HMO regulators oppose the legislation, arguing that current laws and rules give state regulators authority over such issues and that doctors and hospitals can file lawsuits over payment disputes.

Sherrie Lowenstein, an attorney for the Department of Managed Health Care, said that the bill would reduce the department's flexibility to focus on the most serious allegations against HMOs and instead would turn the agency into "a bill collector for providers, who already have the ability to pursue claims against a health plan under the terms of their contracts."

Unclear Prospects
Huffman said that the bill's prospects with the governor are uncertain given the opposition from state regulators and HMOs. Huffman added that his efforts to discuss the bill with the Schwarzenegger administration have not been successful.

Rachel Cameron, a spokesperson for Schwarzenegger, said that the governor has not taken a stance on the measure (Lifsher, Los Angeles Times, 7/15).

For more information, please visit:
http://www.californiahealthline.org/articles/2008/7/15/Schwarzenegger-Weighs-Legislation-on-Insurer-Payments-to-Doctors.aspx?topicID=37



Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

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