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CMA publishes AB 72 payment monitoring workbook

The California Medical Association has published a workbook to help practices identify if payments they receive comply with AB 72's interim payment rules. AB 72—California’s new out-of-network billing and payment law—requires fully insured commercial plans and insurers to make “interim payments” to non-contracted physicians for covered, non-emergent services performed at in-network health facilities, and places limitations on the ability of physicians in such circumstances to collect their full billed charges. The interim rate defined in AB 72 is the greater of the average contracted rate (including only commercial contracts) or 125 ...