Legislation sponsored by the California Medical Association (CMA), AB 1455 and SB 324, prohibit health plans, their contracting medical groups/IPAs, and insurers from engaging in various unfair payment practices. See "Know Your Rights: Identify and Report Unfair Payment Practices" for a summary of unfair payment practices.
The effectiveness of these regulations depends upon physicians and their office staff taking the time to report any unfair payment practices to the appropriate regulator and to CMA. To help physicians and their staff identify the appropriate regulator, CMA has developed a new resource sheet, "Know Your Rights: Filing a Formal Complaint with the Regulator." For step-by-step instructions for filing a formal complaint with the regulator, see "Report Unfair Payment Practices."
CMA RESOURCES: "Know Your Rights: Identify and Report Unfair Payment Practices;" medical-legal On-Call documents #1051, "Physician Complaints about Managed Care Plans," and #1049, "Patient Complaints about Managed Care Plans."