Bills · 2017-2018 Regular Session
Relating to: mandatory health care pricing disclosures. (FE)
Hospitals and health care facilities Medical service — Occupations Physician Plants
- Introduced, stopped here
- Passes Assembly, not reached
- Passes Senate, not reached
- Governor signs, not reached
- Law, not reached
Unfamiliar terms? Glossary
What this bill does
Plain-language analysis by the nonpartisan Legislative Reference Bureau
This bill changes the pricing disclosures required from certain health care
providers and hospitals. Under current law, certain health care providers and
hospitals are required to disclose, among other things, the median billed charge,
which means the amount the health care provider or hospital charged, before any
discount or contractual rate applicable to certain patients or payers was applied,
during a time period set forth in the statutes, and calculated as described in the
statutes. This bill requires health care providers and hospitals to disclose, instead
of the median billed price, the lowest price accepted, which is defined in the bill as
the lowest price a health care provider or hospital accepts as payment in full for a
health care related product or service offered for sale to the public.
The bill also changes the amount of time health care providers and hospitals
have to update certain charge information. Under current law, health care providers
must annually update the document listing 1) the median billed charge, 2) the
Medicare payment to the provider (if the health care provider is certified as a
provider of Medicare), and 3) the average allowable payment from private,
third-party payers, assuming no medical complications, for diagnosing and treating
each of 25 conditions identified by the Department of Health Services for the health
care provider's type. Similarly, current law requires hospitals to update, every
calendar quarter, the document listing 1) the median billed charge, 2) the average
allowable payment under Medicare, and 3) the average allowable payment from
private, third-party payers, assuming no medical complications, for inpatient care
for certain diagnosis-related groups and for certain outpatient surgical procedures.
This bill substitutes the lowest price accepted for the median billed charge and
requires health care providers and hospitals to update the information on a
continuous basis as information is available.