Buchalter Nemer attorneys instrumental in unanimous rulingJanuary 8, 2009. Los Angeles. The CaliforniaSupreme Court today unanimously reversed the Court of Appeal in amatter titled Prospect Medical Group Inc. vs. NorthridgeEmergency Medical Group., to hold that balance billing isillegal under California law. As the Supreme Court explained,balance billing occurs when "emergency room doctors directlybill the patient for the difference between the bill submitted [toan HMO] and the payment received." Buchalter Nemer appellate specialists Harry W.R. Chamberlain IIand Robert Dato wrote the successful petition for review andpreliminary briefs on the merits for the prevailing independentphysician medical groups led by Prospect Medical Group, andBuchalter Nemer attorney Carol Lucas wrote the amicuscuriae brief on behalf of CAPG (California Association ofPhysician Groups). "The decision once and for all takes managed carepatients out of the middle of payment disputes between HMOs andemergency providers" said Ms. Lucas, Co-Chair of BuchalterNemer's Business Practices Group. "It is good forpatients, who have been used to gain leverage, and it is good formanaged care as a whole, because it will compel the providers andpayors to work out between themselves the value of noncontractedservices. Before patients were taken out of the middle,there was no incentive for noncontracted providers to engage withpayers to determine value. Now they must."...
California Supreme Court Holds Balance Billing Illegal
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