The state Senate plans to vote this week to require more transparency around the cost of health care services, part of legislative attempts to make health care in North Carolina more affordable.
The bill calls for hospitals to file quarterly reports with the cost of common procedures, which would allow patients to see which facility is the cheapest. Health care facilities would also be required to provide patients with a good-faith estimate of how much they'll owe, and provide notifications about services that are out-of-network with a higher cost.
Sen. Amy Galey, R-Alamance, is sponsoring the bill, which has backing from Senate leadership.
"There's no other industry that a consumer agrees to pay for a service in advance, with no clue as to what the cost will be and no clue as to what they will be charged in full for those services," she said. "This bill is an attempt to shine a light on every part of the healthcare system, to begin to see where the cost drivers truly exist, and to start to tamp down on those costs."
The new disclosure mandates are part of a wide-ranging, 15-page The bill's other provisions would:
- Reduce regulatory barriers for opening more rehabilitation facilities, partially repealing the "Certificate of Need" process that limits how many new facilities can open in a particular area
- Ban health care providers from charging facility fees outside of a hospital campus or inpatient facility. This would crack down on a practice where a hospital system owns an outpatient primary care office and charges patients a facility fee for routine care visits
- Add new restrictions on insurance companies' use of "prior authorization" to determine whether procedures or medications prescribed by a doctor will be covered by insurance
- Prevent health care providers from sending unpaid health service bills to collections unless they've first provided a line-item bill
- Require the state auditor's office to review cost and billing transparency at health care facilities
North Carolina has some of the highest health care costs in the country, and the bill is one of several this year trying to address the problem. It's unclear if the House will take up the Senate's proposed reforms; in past sessions, each chamber in the legislature has taken separate approaches to the health care affordability problem, and many measures have failed to make it to the governor's desk.
The Senate's approach tends to win support from the insurance industry, while House leaders support changes that have backing from hospitals and doctors.
"This is a comprehensive bill that will address costs from all angles to ensure actual change in patients' lives and in their wallets and their financial futures," Galey said. "This bill is consistent with President Trump's recent executive order, which highlighted the need to empower patients with clear, accurate and actionable health care pricing information."
The N.C. Healthcare Association, which represents the state's hospitals, is currently "prioritizing conversations directly with lawmakers to ensure they have a clear understanding of our perspective," spokeswoman Stephanie Strickland said in a response to a question from 瓜神app about whether the group supports or opposes the bill.
"We believe there are more effective ways to reduce health care costs and look forward to working with legislators in both chambers to achieve that goal," she said.
