Bill Text: IA SF5 | 2021-2022 | 89th General Assembly | Introduced


Bill Title: A bill for an act relating to the disclosure of the prices charged for health services rendered by health care providers and hospitals.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2021-01-12 - Subcommittee: Costello, Green, and Jochum. S.J. 78. [SF5 Detail]

Download: Iowa-2021-SF5-Introduced.html
Senate File 5 - Introduced SENATE FILE 5 BY ZAUN A BILL FOR An Act relating to the disclosure of the prices charged for 1 health services rendered by health care providers and 2 hospitals. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1671XS (1) 89 pf/rh
S.F. 5 Section 1. NEW SECTION . 135.84 Disclosure of prices charged 1 for health services by health care providers and hospitals. 2 1. A health care provider shall disclose and make available 3 to the public in a single document, either electronically or 4 by posting conspicuously on the provider’s internet site, 5 if one exists, the prices charged, prior to the negotiation 6 of any discounts and assuming no medical complications, for 7 the twenty-five most common health services the health care 8 provider renders. 9 a. The health care provider shall identify the health 10 service for which prices charged are provided in both a common 11 procedural terminology code or other coding system commonly 12 used by the health care provider and accepted as a national 13 standard for billing, and in a plain language description. 14 b. The health care provider shall update the price 15 information as frequently as the health care provider deems 16 appropriate, but at least annually. 17 2. A hospital shall disclose and make available to the 18 public in a single document, either electronically or by 19 posting conspicuously on the hospital’s internet site, if 20 one exists, the prices charged, prior to the negotiation of 21 any discounts and assuming no medical complications, for 22 the seventy-five most common inpatient health services and 23 the seventy-five most common outpatient health services, as 24 grouped by a Medicare diagnosis-related group, rendered by 25 the hospital. The price information shall be updated on a 26 quarterly basis. 27 3. Any price information disclosed under this section shall 28 include a disclaimer that the price information provided is 29 an estimate, does not constitute a legally binding charge for 30 a health service provided to a specific consumer, and that 31 the actual charge for a health service is dependent on the 32 circumstances at the time the health service is rendered. 33 4. The department shall adopt rules pursuant to chapter 17A 34 to ensure that requirements under this section are consistent 35 -1- LSB 1671XS (1) 89 pf/rh 1/ 3
S.F. 5 with and do not duplicate federal requirements related to the 1 disclosure of prices charged by health care providers and 2 hospitals including but not limited to the requirements for 3 hospitals pursuant to 42 U.S.C. §300gg-18(e). 4 EXPLANATION 5 The inclusion of this explanation does not constitute agreement with 6 the explanation’s substance by the members of the general assembly. 7 This bill relates to the disclosure of prices charged by 8 health care providers and hospitals for common health services. 9 The bill requires a health care provider to disclose and 10 make available to the public in a single document, either 11 electronically or by posting conspicuously on the provider’s 12 internet site, the prices charged, prior to the negotiation of 13 any discounts and assuming no medical complications, for the 25 14 most common health services the health care provider renders. 15 The health services are to be identified by a common nationally 16 recognized coding system and by a plain language description, 17 and the health care provider is required to update the price 18 information at least annually. 19 The bill requires hospitals to disclose and make available 20 to the public in a single document, either electronically or 21 by posting conspicuously on the hospital’s internet site, the 22 prices charged, prior to the negotiation of any discounts and 23 assuming no medical complications, for the 75 most common 24 inpatient and the 75 most common outpatient health services, as 25 grouped by a Medicare diagnosis-related group, rendered by the 26 hospital. The price information is required to be updated on 27 a quarterly basis. 28 The bill provides that the price information disclosed shall 29 include a disclaimer that the price information provided is 30 an estimate, does not constitute a legally binding charge for 31 a health service provided to a specific consumer, and that 32 the actual charge for a health service is dependent on the 33 circumstances at the time the service is rendered. 34 The bill directs the department of public health to adopt 35 -2- LSB 1671XS (1) 89 pf/rh 2/ 3
S.F. 5 administrative rules to ensure that requirements under the bill 1 are consistent with and do not duplicate federal requirements 2 related to the disclosure of prices charged by health care 3 providers and hospitals, specifically including those required 4 under the federal Affordable Care Act regarding the publicizing 5 of standard hospital charges. 6 -3- LSB 1671XS (1) 89 pf/rh 3/ 3
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