Fee Dispute Proposal Tabled for Study
[Posted 08/11/05]

CMA’s Board of Trustees voted Tuesday to affirm current CMA policy supporting physicians’ right to balance bill when payors fail to adequately reimburse physicians for covered services provided to health plan enrollees.

As reported in last month’s Physician Leader, CMA’s trustees at the July 29 board meeting debated a proposal to establish pilot projects that test various dispute resolution mechanisms to adjudicate payment disputes in an effort to reduce or eliminate balance billing of HMO patients. The trustees determined that supporting such projects would require a change in CMA’s house policy. CMA last week sent a letter to CMA’s more than 500 delegates explaining the proposed legislation and requesting that they make their views known to the board.

“CMA leaders and senior staff do not support the idea eliminating or restricting balance billing,” says CMA CEO Jack Lewin, M.D. “But the concept of a fee dispute pilot project is interesting and will be thoroughly explored before next year's legislative session begins.”

After receiving input on the pilot project proposal from the delegates, the trustees decided to affirm CMA’s current policy—which opposes any attempts to prohibit balance billing—and to instead appoint a committee to study and report back to the board on various dispute resolution mechanisms.

Click here for a copy of CMA’s letter to the trustees on this issue.

Contact: CMA Government Relations, 916/444-5532 or leginfo@cmanet.org.