HLS 14RS-557 ENGROSSED
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Regular Session, 2014
HOUSE BILL NO. 251
BY REPRESENTATIVES TALBOT AND SIMON
HEALTH SERVICES: Requires provision of cost estimates to patients for procedures at
hospitals and ambulatory surgical centers
AN ACT1
To enact Part I-A of Chapter 11 of Title 40 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 40:2031 through 2039, and to repeal R.S. 40:2010, relative to3
consumer information concerning prices of certain health care services; to provide4
for legislative intent; to prohibit hospitals from assessing certain charges; to provide5
for requirements of hospitals and ambulatory surgical centers relative to disclosure6
of certain cost information to consumers; and to provide for related matters.7
Be it enacted by the Legislature of Louisiana:8
Section 1. Part I-A of Chapter 11 of Title 40 of the Louisiana Revised Statutes of9
1950, comprised of R.S. 40:2031 through 2039, is hereby enacted to read as follows:10
PART I-A. TRANSPARENCY IN HOSPITAL11
AND SURGICAL CENTER PRICES AND POLICIES12
SUBPART A. BILLED SERVICES BY HOSPITALS13
§2010. §2031. Itemized statement of billed services by hospitals14
Not later than ten business days after the date of discharge, each hospital in15
the state which is licensed by the Department of Health and Hospitals shall have16
available an itemized statement of billed services for individuals who have received17
the services from the hospital. The availability of the statement shall be made known18
to each individual who receives service from the hospital before the individual is19
discharged from the hospital, and a duplicate copy of the billed services statement20 HLS 14RS-557 ENGROSSED
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shall be presented to each patient within the specified ten day ten-day period. No1
insurance company, employee benefit trust, self-insurance plan, or other entity which2
is obligated to reimburse the individual or to pay for him or on his behalf the charges3
for the services rendered by the hospital shall pay those benefits to the individual4
when the itemized statement submitted to such entity clearly indicates that the5
individual's rights to those benefits have been assigned to the hospital. When any6
insurance company, employee benefit trust, self-insurance plan, or other entity has7
notice of such assignment prior to such payment, any payment to the insured shall8
not release said entity from liability to the hospital to which the benefits have been9
assigned, nor shall such payment be a defense to any action by the hospital against10
that entity to collect the assigned benefits. However, an interim statement shall be11
provided when requested by the patient or his authorized agent.12
SUBPART B. PRICE TRANSPARENCY13
§2032. Legislative intent14
It is the intent of the legislature to improve transparency in prices of health15
care services through requiring provision of information to the public on the costs16
of the most frequently reported diagnosis-related groups for hospital inpatient care,17
and for the most common surgical procedures and imaging procedures provided in18
hospital outpatient settings and ambulatory surgical centers.19
§2033. Definitions20
As used in this Subpart, the following terms have the meaning ascribed to21
them in this Section:22
(1) "Ambulatory surgical center" means a facility licensed as an ambulatory23
surgical center pursuant to the provisions of Part IV of this Chapter (R.S. 40:213124
et seq.).25
(2) "Hospital" means a facility licensed as a hospital pursuant to the26
provisions of Part II of this Chapter (R.S. 40:2100 et seq.).27 HLS 14RS-557 ENGROSSED
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§2034. Provision of cost information to patients1
A. Upon the request of a patient, a hospital or ambulatory surgical center2
shall provide an estimate for the amount to be charged to the patient for a particular3
service.4
B. The hospital or ambulatory surgical center shall provide the estimate5
within seven days of the request by the patient. If the patient requests the estimate6
verbally, the hospital or ambulatory surgical center may provide the estimate7
verbally. If the patient requests the estimate in writing, the hospital or ambulatory8
surgical center may furnish the estimate to the patient either electronically or by9
mail.10
C. The estimate provided shall be considered a non-binding estimate based11
on the information provided by the patient or the patient's treating physician to the12
hospital or ambulatory surgical center at the time of the request and not a guarantee13
of the final charge for services delivered.14
§§2035 through 2039. [Reserved.]15
Section 2. R.S. 40:2010 is hereby repealed in its entirety.16
Section 3. This Act shall become effective upon signature by the governor or, if not17
signed by the governor, upon expiration of the time for bills to become law without signature18
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If19
vetoed by the governor and subsequently approved by the legislature, this Act shall become20
effective on the day following such approval.21
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Talbot HB No. 251
Abstract: Requires provision of cost estimates to patients for procedures at hospitals and
ambulatory surgical centers.
Proposed law provides that the intent of proposed law is to improve transparency in prices
of health care services through requiring provision of information to the public on costs of
the most frequently reported diagnosis-related groups for hospital inpatient care, and for the HLS 14RS-557 ENGROSSED
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most common surgical procedures and imaging procedures provided in hospital outpatient
settings and ambulatory surgical centers.
Proposed law retains and relocates present law relative to itemized statements of billed
services by hospitals.
Proposed law adds the following requirements and conditions relative to disclosure of prices
of healthcare services to patients:
(1)Upon the request of a patient, hospitals and ambulatory surgical centers shall provide
an estimate for the amount to be charged for a particular service.
(2)Hospitals and ambulatory surgical centers shall provide the estimate of the amount
to be charged within seven days of the request by the patient verbally, if requested
verbally; and in writing, either electronically or by mail, if requested in writing.
(3)The estimate of the amount to be charged shall be considered a non-binding estimate
based on the information provided by the patient or the patient's treating physician
at the time of the request, and not a guarantee of the final charge for services
delivered.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 40:2031-2039; Repeals R.S. 40:2010)
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Health and Welfare to the
original bill.
1. Deleted provision stipulating that it shall be unlawful for any hospital to charge
or accept payment for any health care procedure or component of any health care
procedure that it did not perform or supply.
2. Deleted the following defined terms and their corresponding definitions: "CPT",
"Department", "DRG", "HCPCS", "Health insurer", "Public or private third
party".
3. Deleted requirement that DHH make available to the public on its website certain
price information it would have received from hospitals and ambulatory surgical
centers pursuant to deleted provisions of proposed law.
4. Deleted requirement that hospitals provide the following information for
publication by DHH concerning the 100 most frequently reported admissions by
diagnosis-related group (DRG) for inpatients:
(a)The amount that will be charged to a patient for each DRG if all charges
are paid in full without a public or private third party paying for any
portion of the charges.
(b)The average negotiated settlement on the amount that will be charged to
a patient as provided for in (a).
(c)The total amount of Medicaid reimbursements for each DRG, including
claims and pro rata supplemental payments.
(d)The total amount of Medicare reimbursements for each DRG. HLS 14RS-557 ENGROSSED
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(e)For the five largest health insurers providing payment to the hospital on
behalf of insured patients, the range of the total amount of payments
made for each DRG, with information identifying insurers redacted.
5. Deleted requirement that hospitals and ambulatory surgical centers provide
information for publication by DHH on the total costs for the 20 most common
surgical procedures and the 20 most common imaging procedures, by volume,
performed in hospital outpatient settings or in ambulatory surgical centers, along
with the related Current Procedural Terminology (CPT) and Healthcare Common
Procedure Coding System (HCPCS) codes.
6. Deleted requirement that upon request of a patient for a particular DRG, imaging
procedure, or surgery procedure, a hospital or ambulatory surgical center shall
furnish cost information on the procedure to the patient in writing within three
days. Added in lieu thereof the following requirements and conditions:
(a)Upon the request of a patient, hospitals and ambulatory surgical centers
shall provide an estimate for the amount to be charged for a particular
service.
(b)Hospitals and ambulatory surgical centers shall provide the estimate in
(a) within seven days of the request by the patient verbally, if requested
verbally; and in writing, either electronically or by mail, if requested in
writing.
(c)The estimate in (a) shall be considered a non-binding estimate based on
the information provided by the patient or the patient's treating physician
at the time of the request, and not a guarantee of the final charge for
services delivered.
7. Deleted requirement that certain tax-exempt hospitals and ambulatory surgical
centers disclose their charity care policies and costs to patients, and to provide
these policies and costs for publication by DHH.
8. Deleted provisions for rulemaking by DHH that were rendered inoperable by
other deletions made by Committee Amendments.
9. Made technical changes.