Health Care Prices Revealed and Information to Consumers Explained Transparency Act
Impact
If enacted, SB3548 would significantly alter current healthcare regulations by ensuring that hospitals and group health plans adhere to strict disclosure requirements. Effective from January 1, 2025, the statute aims to eliminate confusion around healthcare pricing by requiring detailed listing of standard charges, including gross and discounted cash prices. Furthermore, it establishes enforcement mechanisms, including civil monetary penalties for non-compliance, which could lead to improved adherence among providers and increased accountability.
Summary
SB3548, officially titled the Health Care Prices Revealed and Information to Consumers Explained Transparency Act, seeks to enhance price transparency in healthcare, specifically among hospitals and insurers. The bill mandates hospitals to publicly disclose their standard charges and the costs associated with various services, compelling them to provide this information in a consumer-friendly format. This transparency aims to empower consumers by giving them clearer insights into healthcare costs, fostering better decision-making and potentially reducing out-of-pocket expenses for patients.
Contention
While supporters argue that the bill will help consumers make informed choices about their healthcare options, there are concerns about the feasibility and potential backlash from healthcare providers. Critics fear that mandates to disclose sensitive pricing information may inadvertently lead to increased costs or limit negotiations between insurers and providers, ultimately hindering competition. Additionally, the transition to compliance may impose operational challenges on healthcare institutions, particularly smaller hospitals that may lack the infrastructure to meet these new requirements.
Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act This bill provides statutory authority for requirements for hospitals and health insurance plans to disclose certain information about the costs for items and services. Specifically, hospitals must publish in their list of standard charges certain rates negotiated with insurers, discounts for cash payments, and billing codes. Further, hospitals generally must publish the standard charges for the services provided by the hospital that may be scheduled in advance. Additionally, insurance plans must publish the in-network and out-of-network charges for covered items and services and the negotiated prices for covered prescription drugs. Plans must provide a tool for consumers to search for this cost information. Consumers also may request additional information about the costs of specific items or services under their plans.
Health Care Prices Revealed and Information to Consumers Explained Transparency Act or the Health Care PRICE Transparency Act This bill provides statutory authority for requirements for hospitals and health insurance plans to disclose certain information about the costs for items and services. Specifically, hospitals must publish in their list of standard charges certain rates negotiated with insurers, discounts for cash payments, and billing codes. Further, hospitals generally must publish the standard charges for the services provided by the hospital that may be scheduled in advance. Additionally, insurance plans must publish the in-network and out-of-network charges for covered items and services and the negotiated prices for covered prescription drugs. Plans must provide a tool for consumers to search for this cost information. Consumers also may request additional information about the costs of specific items or services under their plans.
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