California Supreme Court Rules Against Balance Billing

The Supreme Court of California recently issued a decision prohibiting hospital emergency departments from billing patients directly for amounts disallowed by their insurance plans. This controversial practice is commonly known as balance billing, and it has been a heated issue in California in recent months.

Unfortunately, the court declined to address the issue of reasonable and customary fees. Balance billing exists as a practice because providers and payors disagree over what constitutes an appropriate fee for health care services. Until a consensus is reached, medical billing practices may remain controversial.