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One in five patients who get elective surgery at U.S. hospitals that accept their insurance may still get surprise medical bills, especially if they receive anesthesia, a new study suggests.

The study looked at what happened to almost 350,000 patients who had non-emergency surgery between 2012 and 2017 at hospitals and clinics that belonged to their health plan network, using surgeons who accepted their insurance.

Even among those who did their best to go where their insurance was accepted, 21% still got surprised by out-of-network bills. And tabs were not small, ave...

The knock came just four days after Steven Krueger got out of the hospital. He was recovering from back surgery in his home in Idaho Falls when sheriff's deputies arrived with a warrant to bring him to the courthouse.


Steve was in a back brace and wasn't supposed to travel, except to the doctor.

"I just kind of stood there stunned," says Mari Krueger, Steve's wife. "I was just horrified ... I was almost hysterical."

Mari wasn't stunned by Steve's arrest simply because of his condition. She was also shocked because he wasn't accused of committing a crime. What he...

The DC District Court cited damaging market ownership and considerably large anti-competitive implications as basis for the Cigna-Anthem merger block.

The full opinion of United States District Court for the District of Columbia blocking Anthem’s acquisition of Cigna became publicly available earlier this week and provides details into the court’s decision.

In the memorandum opinion, Judge Amy Berman Jackson based the bulk of her decision on the effects of the Anthem-Cigna merger on market competition. In particular, the judge keyed in on the example of the insurance...

California has one the nation’s lowest number of hospital emergency rooms per capita, and Bay Area legislators are calling this shortage a crisis, as the number of people who need urgent care services keeps growing. They are pushing for a bill that would require non-profit hospitals to obtain approval from the state Attorney General and hold at least one public hearing before closing their emergency departments.

In February, California State Senator Nancy Skinner, who represents the 9th District covering both Richmond and Oakland, introduced Senate Bill 687, designe...

The megamerger between the health insurers Aetna and Humana has been blocked by a federal judge.

The deal, in which Aetna proposed to buy Humana for $37 billion, has been ruled anticompetitive by US District Judge John Bates.

"In this case, the government alleged that the merger of Aetna and Humana would be likely to substantially lessen competition in markets for individual Medicare Advantage plans and health insurance sold on the public exchanges," Bates' decision said.

"After a 13-day trial, and based on careful consideration of the law, evidence, and arguments, th...

The Association of American Physicians and Surgeons (AAPS) filed suit in U.S. District Court on Friday asking the Court to block California AB 72, the so-called “Surprise Medical Bill” law signed last month by Governor Jerry Brown.

“This new law gives insurance bureaucrats the power to decide what out-of-network physicians can be paid for life-saving medical care,” said AAPS General Counsel Andrew Schlafly. “Independent doctors, already under attack from all directions, could be forced to shut their doors. Patients are already having trouble finding doctors, and thi...

Gov. Jerry Brown is approving legislation that seeks to stop surprise medical bills from doctors not covered by a patient’s health plan.

Brown said he’s signed AB72 by Assemblyman Rob Bonta of Alameda.

Unions and patient advocacy groups say patients shouldn’t face massive bills if they visit a hospital that accepts their insurance but are treated by a doctor who doesn’t. Unexpected bills commonly come from radiologists, pathologists and anesthesiologists who get involved in diagnosing or caring for hospitalized patients.

“This is a big win for Californians who have be...

The N.C. Department of Insurance has levied a record $3.6 million fine against Blue Cross and Blue Shield of North Carolina for chronic malfunctions that have led to billing and enrollment errors for Blue Cross customers since January.

The Insurance Department and Blue Cross, the state’s largest health insurer, agreed to the fine amount Thursday, ending a six-month agency investigation in what has been the most challenging year in the insurance company’s history. The agency cited a spate of problems, including over-billing, double-billing, failing to confirm coverag...

Cigna defended its sale to Anthem in a court filing this week, saying it would benefit consumers by giving them greater access to affordable health care. The filing comes two months after the U.S. Justice Department sued to block the $54 billion deal.

Bloomfield-based Cigna complained, as Anthem did in July, that government attorneys used misleading quotes out of context from internal documents, and said it agreed with Anthem's view that the $48 billion deal would give consumers greater access to affordable health care.

The federal government claims that ma...

AB 72 passed both the California Senate and Assembly. It is has been sent to Governor Brown where he has until the end of the month to sign the bill into law or veto it. If patients are admitted to an in-network facility, there is a chance that one or more providers who provide patient care may not be in-network. If this happens, a patient may be billed directly from the out-of-network provider for the full amount of services. Under AB 72, for health plan contracts and health policies issued, amended, or renewed on or after July 1, 2017, the out-of-network provider...

For the second time in as many years, California legislators are debating a bill that would protect patients from paying surprise medical bills when they inadvertently get treatment from doctors who are not covered by their insurance.

Under the bill, AB 72, consumers would only pay the equivalent of in-network rates if, for example, during surgery covered by insurance, they are treated by an out-of-network anesthesiologist, or have X-rays read by an out-of-network radiologist. AB 72 is in the California Senate and must be approved before going to the state assembly...

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