Health Care Transparency Bill: A Snapshot Of What It Entails

Over the years, the healthcare sector has received quite a bit of flak for its unwillingness, or inability, to share costs of services beforehand with their patients. The Health Care Price Transparency Bill that was recently passed by the Florida State Senate hopes to change this trend, therefore, giving patients the liberty to consider fee structures as one of the parameters for choosing a provider.

Many of us have had the misfortune of receiving an unexpected medical bill in the mail, at some point in our lives. Such an experience is not desirable, to say the very least. In the past, people did not have much of choice but to swallow the unpleasantness like a bitter pill. Today, the story has changed considerably. Patients are responsible for a significant chunk of the costs associated with their health care. Consequently, they are more alert about what shows up on the bills presented to them. They have more questions and are often unwilling to foot ‘surprise’ bills. In an effort towards eliminating the possibility of such ‘surprises’, the State of Florida passed a bill that imposes pre-service transparency obligations on healthcare entities of all kinds. It lays out some ground rules for facilities that will help promote price transparency. The most salient features of this bill are as follows:

  1. Publication Of Price Range For Common Procedures – The law states that every healthcare facility needs to prepare a list of their 50 most commonly performed procedures along with the rates. Making this list available publicly and readily to patients is essential to promote transparency.
  2. Availability Of Price List Online – Posting a list of average payment amounts and the payment ranges that the facility has received for service bundles that have been delivered is also a requirement as per this bill. The AHCA defines these bundles. Patients should be able to search for this information and find it easily on the internet.
  3. Provision Of An Estimate Of Charges – A health care entity must be prepared to provide an estimate of the overall charges that will be incurred by the patient, including the facility fees. The patient should receive this information within seven days of placing the request.
  4. Sending An Itemized Bill Post-Service – Facilities must send the patient a bill that clearly states the break-up of charges within seven days of discharge. If providers who bill separately were part of the care process, this information is to be added.

It is vital for health care professionals and facilities to comprehend the nuances of this bill to avoid fines to the tune of $10,000 per day. Re-engineering processes to fit the requirements of this bill will also help practices become more patient-friendly and compliant.

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