Would any payor pay a physician or medical group more than Medicare plus 25% if they didn’t have to?
Would any payor with the ability to control what its “average” contract rate is, reduce its “average” if that’s all it has to pay to an out-of-network physician or medical group?
California’s law known as “AB 72,” purportedly passed to stop the “evils” of “surprise” medical bills in the nonemergency setting (that’s the situation a patient encounters when he or she gets treatment at an in-network facility from an out-of-network physician or other health care professional) will have an (intended?) disastrous impact on both out-of-network and in-network physicians and medical groups.
