Here’s what you should note:
1. The legislation places a cap on the amount out-of-network-surgeons and other providers can bill patients for covered non-emergency services that ASCs and other facilities offer.
2. Under the law, ASCs and other facilities have to bill enrollees the same cost-sharing amount the enrollee would pay a contracted professional for the same service.
3. Additionally, a patient’s plan must inform both an enrollee and the non-contacted professional on the in-network cost-sharing amount the enrollee owes.
4. JD Supra advises ASCs and non-contracted professionals to carefully look over their collection policies and procedures to ensure they are complying with the law.
For more on Assembly Bill 72, click here.
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