The balancing role of balance billing.
A recent court case, Prospect Medical Group, Inc. v. Northridge Emergency Medical Group et al., has ruled that emergency physicians are allowed to balance bill health plan subscribers when the plan itself underpays the providers. Partly at issue was whether the providers' contract with the health plan was only implied. The court's advice: Put all contracts in writing.
Fedor
Frank
F
Murphy Austin Adam Schoenfeld LLP, Sacramento, Calif., USA. ffedor@murphyaustin.com
D005102:Health Expenditures; D008329:Managed Care Programs; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence*; D014481:United States