Regards limitations imposed by health insurers on dental care
Impact
The proposed changes are likely to have significant implications for healthcare service providers in Ohio. By mandating that providers disclose estimated costs for non-covered services and clarifying the payment structures for these services, the bill seeks to reduce the potential for financial surprises for patients. Additionally, the adjustments to business practices for health insurers aim to foster a more consumer-friendly environment, empowering patients with crucial cost information upfront, which could ultimately lead to more competitive healthcare pricing.
Summary
House Bill 160 aims to amend various sections of the Revised Code regarding restrictions placed by health insurers on dental and vision care services. The primary focus of the bill is to ensure that health insurance entities provide clear and accessible information to enrollees regarding coverage and costs associated with both covered and non-covered dental and vision services. This amendment is intended to enhance transparency between providers and enrollees, promoting informed decision-making for consumers when selecting care and services.
Sentiment
Overall, the sentiment surrounding HB 160 appears to be cautiously optimistic, with many stakeholders recognizing the need for increased transparency in the healthcare marketplace. Supporters of the bill, including consumer advocacy groups, argue that it will enhance patient autonomy and choice, whereas some insurance industry representatives have raised concerns regarding the operational implications and potential increased administrative burdens associated with complying with the new disclosure requirements.
Contention
Notable points of contention revolve around the implementation and feasibility of the additional requirements placed on health providers and insurers. Some industry stakeholders express worry that the required disclosures may not only increase administrative costs but also lead to unintended consequences, such as reducing the number of participating providers in certain networks. Additionally, there is concern about the bill's language concerning the potential for disputes arising from misunderstood estimates, which could lead to increased litigation or dissatisfaction among enrollees.
Insurance: health insurers; granting third party access to a dental network contract; allow. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406aa.
Expanding limitations to third-party access to provider network contracts and discounts unless certain criteria are met and prohibitions on payment method restrictions and limitations on certain transaction fees from dental services to all healthcare services.
Concerns the delivery and oversight of coverage under certain health benefits plans; establishes Health Care Patient Ombudsperson in the Division of Consumer Affairs.
An Act Concerning Contracts Between Health Carriers And Health Care Providers, Agents Or Vendors, Participating Provider Directories And Surprise Bills.