More people are being illegally billed for charges not paid by Medi-Cal

Lisa Zamosky
September 18, 2015


Healthcare providers are prohibited by law from billing people with Medi-Cal for charges not covered by their insurance. Yet, according to advocates, there has been an increase over the last year in healthcare providers engaging in the practice, commonly referred to as balance billing.

“We get a significant number of people with Medi-Cal being impermissibly balance billed,” said Stephanie Lee, supervising attorney at the Neighborhood Legal Services of Los Angeles County’s (NLSLA) health consumer center.

Balance billing is particularly prevalent among Medi-Cal recipients who also qualify for Medicare. A recent report by the federal Centers for Medicare and Medicaid Services revealed a nationwide trend of healthcare providers illegally billing these individuals for charges not covered by either type of insurance. In California, Lee said, the call volume NLSLA’s help line doubled in the last year in largely due to complaints about balance billing.

According to Georgia Burke, directing attorney with Justice in Aging, the problem stems, in part, from providers and patients who “don’t understand what the protections are.”

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Organizations mentioned/involved: Neighborhood Legal Services of Los Angeles County (NLSLA), Justice in Aging