On Sept. 13, physicians testified at a public hearing in Burbank about Gov. Arnold Schwarzenegger's three proposed regulations impacting emergency care billing practices.

The all-day hearing was hosted by the California Department of Managed Health Care, which will implement the regulations if adopted. The regulations would ban noncontracted physicians from billing insured patients for emergency care services, also known as balance billing; establish an independent dispute resolution process; and change the criteria for determining payment. (See "Billing Fight")

Members of the DMHC's Financial Solvency Standards Board presided over the hearing, including Cindy Ehnes, DMHC director, and Keith Wilson, MD, CEO of Talbert Medical Group.

"Gov. Schwarzenegger has asked us to take every step to protect patients from balance billing," Ehnes said. "Patients are often put in the middle of billing disputes between emergency room physicians and on-call specialists, and health plans and insurance companies. We want to take the patient out of the equation."

Several physicians argued vehemently against the proposals, stating that they will result in disintegrating call panels, an increase in emergency room wait times and compromised quality of care.

"The specialists will go first, including the neurosurgeons, trauma surgeons and orthopedic surgeons," said James Hinsdale, MD, vice chair of the California Medical Association board of trustees. "The few trauma centers that are open will be overwhelmed."

The DMHC also planned to hold additional hearings in San Diego and Sacramento. After the comment period ends Oct. 4, the department will review the recommendations. If the DMHC decides to make changes, it will publish the revised regulations by early November, says a DMHC spokeswoman.