Petition: Stop In-Network Doctors from Charging Mandatory Annual Fees

In California, an increasing number of in-network doctors are imposing mandatory out-of-pocket annual fees—ranging from hundreds to thousands of dollars—on patients who wish to initiate or continue care. These fees are not covered by insurance and are not optional; they are prerequisites for receiving care from providers who are ostensibly within the patient's insurance network.

These charges are not for specific medical services or procedures. Instead, they are often justified with vague explanations — like "we need to cover administrative costs or high rent", and "insufficient insurance reimbursements." However, when a doctor chooses to remain in-network, they are expected to adhere to the contractual obligations that come with that status, including accepting the insurance terms agreed upon and not pass their financial frustrations onto the public.

This practice is ethically questionable at best, and financially exclusionary. It disproportionately affects seniors, individuals with chronic, complex, or higher-risk conditions, and underserved communities, exacerbating existing healthcare disparities. But it’s not just low-income individuals—individuals and families with budgets are also being priced out of routine care simply because they refuse to pay twice. Moreover, these fees are frequently disclosed only after patients attempt to book appointments or transfer medical records, placing them in a difficult position during an already stressful process.

We, the undersigned, urge the California Department of Managed Health Care (DMHC), the California Department of Insurance (CDI), and other relevant regulatory bodies to:

1) Prohibit in-network healthcare providers from charging mandatory annual fees.
2) Investigate and address this growing practice among healthcare providers.
3) Hold accountable those who violate insurance contracts or exploit loopholes to undermine patient rights and protections.
4) Enforce existing insurance contracts to ensure patient rights and protections are upheld.
5) Ensure equitable access to healthcare by eliminating these income-based barriers within insurance networks.
6) Protect patients from being denied care for refusing to pay non-covered fees.

Actions Patients and Ethical Practitioners Can Take:

For Patients:
1) Decline to pay unjustified annual fees and seek providers who honor insurance agreements.
2) Communicate your concerns to healthcare providers and their administrative staff.
3) Share your experiences on platforms like Yelp, Google Reviews, and Healthgrades to inform others.
4) Report such practices to the DMHC or CDI.
5) Support and recommend ethical healthcare providers who do not impose such fees.

For Healthcare Providers:
1) Refrain from charging mandatory annual fees and uphold the integrity of in-network agreements.
2) Advocate within the medical community for equitable patient access and against exclusionary practices.
3) Support patients who raise concerns and promote transparency in billing practices.

Healthcare should be accessible and fair. Mandatory annual fees imposed by in-network doctors undermine the trust and financial stability of patients. It's time for California to take the lead in standing against this coercive practice.