AB 72: What the new CA “out-of-network” law means

Assembly Bill 72 was signed into law by Governor Brown on September 23, 2016.  As of July 1, 2017, this new law will impose additional balance-billing prohibitions on “non-contracted” physicians beyond the current balance-billing prohibition for emergency services to patients covered by health care service plans. The law requires health plans and insurance companies to inform non-contracted physicians of the “in-network cost sharing amount” for which patients are responsible. The law establishes an independent dispute resolution process to determine the amount health plans and insurance companies must pay non-contracted physicians.