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January 8, 2009
 California Supreme Court Ruling on Prospect Medical Group, Inc., et al.,
v. Northridge Emergency Medical Group et al.
The California Supreme Court ruled that patients
cannot be held liable for the balance between what health maintenance
organization (HMO) providers want to pay for emergency room services by
out-of-network providers. The ruling means an end to the practice of
balance billing, in which the patient receives a bill from a provider for
the remainder of the bill left after the patients insurance pays the
provider. Billing disputes over emergency care must be resolved between
the provider and the HMO obligated to make that payment. The ruling
applies only to consumers enrolled in HMOs in California.
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OPEN MINDS