HF 61 (LSB 1069YH (2) 91)

HOUSE FILE 61

BY  WILLS

A BILL FOR

An Act relating to the disclosure of prices charged for certain health services rendered by health care providers and hospitals.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  10A.703  Disclosure of prices charged for health services by health care providers and hospitals.
   1.  A health care provider shall disclose and make available to the public in a single document, either electronically or by posting conspicuously on the provider’s internet site, if one exists, the prices charged, prior to the negotiation of any discounts and assuming no medical complications, for the twenty-five most common health services the health care provider renders. 
   a.  The health care provider shall identify the health service for which prices charged are provided in both a common procedural terminology code or other coding system commonly used by the health care provider and accepted as a national standard for billing, and in a plain language description.
   b.  The health care provider shall update the price information as frequently as the health care provider deems appropriate, but at least annually.
   2.  A hospital shall disclose and make available to the public in a single document, either electronically or by posting conspicuously on the hospital’s internet site, if one exists, the prices charged, prior to the negotiation of any discounts and assuming no medical complications, for the seventy-five most common inpatient health services and the seventy-five most common outpatient health services, as grouped by a Medicare diagnosis-related group, rendered by the hospital. The price information shall be updated on a quarterly basis. 
   3.  Any price information disclosed under this section shall include a disclaimer that the price information provided is an estimate, does not constitute a legally binding charge for a health service provided to a specific consumer, and that the actual charge for a health service is dependent on the circumstances at the time the health service is rendered.
   4.  The department shall adopt rules pursuant to chapter 17A to ensure that requirements under this section are consistent with and do not duplicate federal requirements related to the disclosure of prices charged by health care providers and hospitals including but not limited to the requirements for hospitals pursuant to 42 U.S.C. §300gg-18(e).
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to the disclosure of prices charged by health care providers (providers) and hospitals for certain health services (services).
   The bill requires a provider to disclose and make available to the public in a single document, either electronically or by posting conspicuously on the provider’s internet site, the prices charged, prior to the negotiation of any discounts and assuming no medical complications, for the 25 most common services the provider renders. The services are to be identified by a common nationally recognized coding system and by a plain language description, and the provider is required to update the price information at least annually.
   The bill requires hospitals to disclose and make available to the public in a single document, either electronically or by posting conspicuously on the hospital’s internet site, the prices charged, prior to the negotiation of any discounts and assuming no medical complications, for the 75 most common inpatient and the 75 most common outpatient services, as grouped by a Medicare diagnosis-related group, rendered by the hospital. The price information is required to be updated on a quarterly basis. 
   The bill provides that the price information disclosed shall include a disclaimer as detailed in the bill.
   The bill directs the department of inspections, appeals, and licensing to adopt rules to ensure that requirements under the bill are consistent with and do not duplicate federal requirements related to the disclosure of prices charged by providers and hospitals, specifically including those required under the federal Affordable Care Act regarding the publicizing of standard hospital charges.