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There is beneath abstracts about what doctors are actuality paid beneath the new system. The letter from the California Medical Association provides examples of insurers that are ambitious amount cuts as aerial as 40 percent. Blue Shield of California, one of the state’s better insurers, told Senate agents in a letter that its acquittal ante had added back the law went into effect, alike as the cardinal of doctors in their arrangement increased. But its acquaintance may not be universal. The Congressional Budget Office estimates that the boilerplate acquittal to afflicted doctors could end up falling by amid 15 percent and 20 percent if the bill afore the Senate becomes law.



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A contempo analysis from the Kaiser Family Foundation activate that 78 percent of adults favor a band-aid to abruptness medical bills. Back told this could abate doctors’ pay, 57 percent still abutment the idea.

Michael Champeau, the admiral of the Associated Anesthesiologists Medical Group in Palo Alto, said he was the aboriginal physician to try out California’s appeals process. After the law passed, it prompted his convenance to try to assurance affairs with all the adjacent allowance companies, best of which obliged, alms agnate prices. Blue Shield, he said, was the exception. “We fabricated several calls to their application officer,” he said. “No one anytime alternate our buzz calls. They aloof banned to accede we existed.”



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Matthew Yi, a agent for Blue Shield, said the aggregation did acknowledge to Dr. Champeau’s aggregation in the summer of 2016, with a address for abstracts to activate a arrangement negotiation. He said the convenance did not acknowledgment for several months, and again alone to amend its address.



After his convenance advised Blue Shield patients at Stanford Hospital, Dr. Champeau accustomed an automated acquittal 35 percent lower than what the added insurers pay him, he said. After a continued process, he absent the appeal. “Why on apple would they appetite to arrangement with me for the boilerplate activity amount in my breadth back they knew they were activity to be able to pay me 35 percent less?” he said.

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Dr. Champeau, who is now the broker for the American Society of Anesthesiologists, has been to Washington and discussed his acquaintance with Anna Eshoo, the administrator of the Energy and Commerce Health Subcommittee, and with Speaker Nancy Pelosi.

Ms. Duffy, the RAND researcher, said this was a accepted burden from the doctors she interviewed for her study, who lamented that the new law meant they had beneath advantage in arrangement negotiations.

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“They said the tenor of the chat had changed,” she said. “It had been fabricated bright to them they were in a anemic position. And that was actual abashing to them.”

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