The California Medical Association House of Delegates passed a resolution in late October about noncontracted billing for services rendered, also known as balance billing.

Delegates vigorously opposed the Department of Managed Health Care's August 2006 proposed regulations that would prohibit physicians from billing patients for services rendered. Delegates instructed the CMA to take all action necessary, including legal or legislative, to oppose efforts to limit physicians' billing rights. The resolution came out of Reference Committee D: Insurance and Physician Reimbursement.

The resolution calls for the CMA, in conjunction with other physician organizations, to launch a media and public relations campaign defending the rights of patients and employers to pursue all legal avenues to assure that their insurance contracts are honored in their entirety.

The CMA supports the requirement that health plans pay noncontracted physicians their customary and reasonable charges in full and within the statutory timeframe, in accordance with the current Gould criteria as it applies to emergency or on-call services.

In addition, the CMA is in favor of a voluntary independent dispute resolution process that would test for reasonable payment using the Gould criteria.

Finally, the billing disputes resolution directs the CMA board of trustees to study and consider alternative approaches under antitrust law that physicians can use to resolve noncontracted emergency and on-call payment disputes.