Assembly Bill 533 Aims at Protecting Consumers from Unexpected Medical Bills

Posted: June 23, 2016

by John Hansen

Assemblyman Rob Bonta Authored this Bill to Target Unexpected Out-of-Network Costs

Your in-network doctor refers you to a specialist. You assume that the specialist must be in-network as well. Later you receive unexpected medical bills because somewhere in the process of the various health care services you received there was an out-of-network provider. Consumers insured on California health plans have been complaining about this, and elected officials in Sacramento have taken note.

Assemblyman Rob Bonta, a Yale and Oxford graduate, who was the head of the California State Assembly Health Committee, authored Assembly Bill 533 to protect consumers from this problem. Bonta is a Democrat from the 18^th district representing the Oakland and Alameda County area, but he proudly advocates for consumers across the state.

AB 533 is currently on the Assembly floor, and it is expected to pass.

CAHU, the California Association of Health Underwriters, says they support the bill if it is amended. According to CAHU, “AB 533 will protect consumers from unexpected medical bills if they are treated by an out-of-network provider at an in-network facility… While it still needs a fair resolution regarding adequate provider payments, the bill does include a consumer protection provision to statutorily bar any balance billing of the consumer by the out-of-network provider in order to shield the consumer from disputes between plans and providers.”

Dave Fear, CAHU Vice President of legislation says, “Insurance agents have been looking for a solution to this for 25 years.”

Assemblyman Jim Wood, who is a former dentist from Cloverdale, California, commented on AB 533. “How do we solve this in a way that’s not punitive?” He applauded the author’s efforts. “Bonta got stakeholders in the room to try and solve the problem” regarding unexpected medical bills.