In a much anticipated decision, the California Supreme Court held, in Prospect Medical Group, Inc. v. Northridge Emergency Medical Group, that billing disputes over emergency medical care must be resolved solely between the emergency department physicians and the HMO; emergency department physicians may not bill the HMO enrollee for any disputed amount. When an emergency physician, who has not contracted with the HMO, provides emergency care to a patient that is enrolled in an HMO, the emergency physician only has recourse against the HMO, and not against the patient. The decision was filed by the California Supreme Court on January 8, 2008.Continue Reading California Supreme Court Says “NO” To Balance Billing in the Emergency Room Setting
