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Senate File 19 - IntroducedA Bill ForAn Act 1relating to the disclosure of the prices charged for
2health services rendered by health care providers and
3hospitals.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. NEW SECTION. 135.84 Disclosure of prices charged
2for health services by health care providers and hospitals.
31. A health care provider shall disclose and make available
4to the public in a single document, either electronically or
5by posting conspicuously on the provider’s internet site,
6if one exists, the prices charged, prior to the negotiation
7of any discounts and assuming no medical complications, for
8the twenty-five most common health services the health care
9provider renders.
10a. The health care provider shall identify the health
11service for which prices charged are provided in both a common
12procedural terminology code or other coding system commonly
13used by the health care provider and accepted as a national
14standard for billing, and in a plain language description.
15b. The health care provider shall update the price
16information as frequently as the health care provider deems
17appropriate, but at least annually.
182. A hospital shall disclose and make available to the
19public in a single document, either electronically or by
20posting conspicuously on the hospital’s internet site, if
21one exists, the prices charged, prior to the negotiation of
22any discounts and assuming no medical complications, for
23the seventy-five most common inpatient health services and
24the seventy-five most common outpatient health services, as
25grouped by a Medicare diagnosis-related group, rendered by
26the hospital. The price information shall be updated on a
27quarterly basis.
283. Any price information disclosed under this section shall
29include a disclaimer that the price information provided is
30an estimate, does not constitute a legally binding charge for
31a health service provided to a specific consumer, and that
32the actual charge for a health service is dependent on the
33circumstances at the time the health service is rendered.
344. The department shall adopt rules pursuant to chapter 17A
35to ensure that requirements under this section are consistent
-1-1with and do not duplicate federal requirements related to the
2disclosure of prices charged by health care providers and
3hospitals including but not limited to the requirements for
4hospitals pursuant to 42 U.S.C. §300gg-18(e).
5EXPLANATION
6The inclusion of this explanation does not constitute agreement with
7the explanation’s substance by the members of the general assembly.
8This bill relates to the disclosure of prices charged by
9health care providers and hospitals for common health services.
10The bill requires a health care provider to disclose and
11make available to the public in a single document, either
12electronically or by posting conspicuously on the provider’s
13internet site, the prices charged, prior to the negotiation of
14any discounts and assuming no medical complications, for the 25
15most common health services the health care provider renders.
16The health services are to be identified by a common nationally
17recognized coding system and by a plain language description,
18and the health care provider is required to update the price
19information at least annually.
20The bill requires hospitals to disclose and make available
21to the public in a single document, either electronically or
22by posting conspicuously on the hospital’s internet site, the
23prices charged, prior to the negotiation of any discounts and
24assuming no medical complications, for the 75 most common
25inpatient and the 75 most common outpatient health services, as
26grouped by a Medicare diagnosis-related group, rendered by the
27hospital. The price information is required to be updated on
28a quarterly basis.
29The bill provides that the price information disclosed shall
30include a disclaimer that the price information provided is
31an estimate, does not constitute a legally binding charge for
32a health service provided to a specific consumer, and that
33the actual charge for a health service is dependent on the
34circumstances at the time the service is rendered.
35The bill directs the department of public health to adopt
-2-1administrative rules to ensure that requirements under the bill
2are consistent with and do not duplicate federal requirements
3related to the disclosure of prices charged by health care
4providers and hospitals, specifically including those required
5under the federal Affordable Care Act regarding the publicizing
6of standard hospital charges.
-3-pf/rh
2health services rendered by health care providers and
3hospitals.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. NEW SECTION. 135.84 Disclosure of prices charged
2for health services by health care providers and hospitals.
31. A health care provider shall disclose and make available
4to the public in a single document, either electronically or
5by posting conspicuously on the provider’s internet site,
6if one exists, the prices charged, prior to the negotiation
7of any discounts and assuming no medical complications, for
8the twenty-five most common health services the health care
9provider renders.
10a. The health care provider shall identify the health
11service for which prices charged are provided in both a common
12procedural terminology code or other coding system commonly
13used by the health care provider and accepted as a national
14standard for billing, and in a plain language description.
15b. The health care provider shall update the price
16information as frequently as the health care provider deems
17appropriate, but at least annually.
182. A hospital shall disclose and make available to the
19public in a single document, either electronically or by
20posting conspicuously on the hospital’s internet site, if
21one exists, the prices charged, prior to the negotiation of
22any discounts and assuming no medical complications, for
23the seventy-five most common inpatient health services and
24the seventy-five most common outpatient health services, as
25grouped by a Medicare diagnosis-related group, rendered by
26the hospital. The price information shall be updated on a
27quarterly basis.
283. Any price information disclosed under this section shall
29include a disclaimer that the price information provided is
30an estimate, does not constitute a legally binding charge for
31a health service provided to a specific consumer, and that
32the actual charge for a health service is dependent on the
33circumstances at the time the health service is rendered.
344. The department shall adopt rules pursuant to chapter 17A
35to ensure that requirements under this section are consistent
-1-1with and do not duplicate federal requirements related to the
2disclosure of prices charged by health care providers and
3hospitals including but not limited to the requirements for
4hospitals pursuant to 42 U.S.C. §300gg-18(e).
5EXPLANATION
6The inclusion of this explanation does not constitute agreement with
7the explanation’s substance by the members of the general assembly.
8This bill relates to the disclosure of prices charged by
9health care providers and hospitals for common health services.
10The bill requires a health care provider to disclose and
11make available to the public in a single document, either
12electronically or by posting conspicuously on the provider’s
13internet site, the prices charged, prior to the negotiation of
14any discounts and assuming no medical complications, for the 25
15most common health services the health care provider renders.
16The health services are to be identified by a common nationally
17recognized coding system and by a plain language description,
18and the health care provider is required to update the price
19information at least annually.
20The bill requires hospitals to disclose and make available
21to the public in a single document, either electronically or
22by posting conspicuously on the hospital’s internet site, the
23prices charged, prior to the negotiation of any discounts and
24assuming no medical complications, for the 75 most common
25inpatient and the 75 most common outpatient health services, as
26grouped by a Medicare diagnosis-related group, rendered by the
27hospital. The price information is required to be updated on
28a quarterly basis.
29The bill provides that the price information disclosed shall
30include a disclaimer that the price information provided is
31an estimate, does not constitute a legally binding charge for
32a health service provided to a specific consumer, and that
33the actual charge for a health service is dependent on the
34circumstances at the time the service is rendered.
35The bill directs the department of public health to adopt
-2-1administrative rules to ensure that requirements under the bill
2are consistent with and do not duplicate federal requirements
3related to the disclosure of prices charged by health care
4providers and hospitals, specifically including those required
5under the federal Affordable Care Act regarding the publicizing
6of standard hospital charges.
-3-pf/rh