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Ruling: Hospital bills should reflect ‘reasonable value’ of services
Sacramento Business Journal

An appellate court decision Tuesday in Fresno could have wide-ranging effects on hospitals and health plans in California.

The Fifth District Court of Appeals ruled that hospitals can no longer expect to get reimbursement from health plans in amounts well in excess of the actual value of services provided to plan members.

Overturning a trial court decision two years ago, the appeals court ordered a new trial in Children’s Hospital Central California v. Blue Cross of California to establish damages that reflect the “reasonable value” of services, not the high prices included on hospital “chargemasters” that almost nobody pays.

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