Bill seeks to clarify medical services pricing

Apr 24, 2008

Miami Herald--April 24, 2008


Comparison shopping for a colonoscopy?

It could get a little easier under a bill being considered by the state Senate Thursday that would require pricing information from hospitals for 150 of the most commonly performed medical procedures to be posted on a state website.

Supporters of the Senate proposal say it is a small, but meaningful, step towards creating greater transparency in the healthcare industry, which may help rein in runaway costs and improve quality. It also would build on an overall effort to arm consumers with more information when making healthcare choices. The bill is being sponsored by Sen. Charlie Dean, an Inverness Republican.

Hospitals already submit information to the state’s Agency for Health Care Administration with estimated prices for procedures, as well as infection and morbidity rates, among other cost and quality measures. The information is searchable on The agency will determine which procedures will be listed if the bill passes.

The proposed bill would add to the list the so-called undiscounted prices, which are the rates uninsured patients typically pay.

Brad Ashwell, a consumer advocate for the Florida Public Interest Research Group, said uninsured patients now have little idea of what they will be charged.

”Typically, those without insurance have to pay the full undiscounted price for their medical needs,” Ashwell said.

Hospitals would also have to supply uninsured patients with an estimate of charges when they visit a hospital for nonemergency care, as well as inform them of discounts and charity programs for which they might qualify. A House version further requires hospitals to notify patients if Medicaid or Medicare only partially covers their care, said Rep. Juan Zapata, a Miami Republican, sponsor of the House measure.

It has yet to be scheduled for a vote in the House.

Zapata said the hospital lobby is holding up the bill because it calls for a study comparing tax exemptions received by nonprofit hospitals with the benefits they provide to the community.

”What I want is for people to know what the costs are . . . It’s unfair for folks not to see the undiscounted rates,” Zapata said, adding that the uninsured would be better able to negotiate. “We don’t know how to be good healthcare consumers, so how do you change that? You provide information.”

Ashwell said medical prices were skyrocketing and consumers have little information to compare until they receive their bill — averages, as currently provided, don’t cut it.

”This would not be tolerated with any other industry,” Ashwell said. “If prices are available, it will create some competition in areas like Miami-Dade and Broward where you have a number of hospitals offering the same services.”

The Florida Hospital Association does not oppose the bill, said Rich Rasmussen, a spokesman for the industry group, yet he pointed out hospitals had been singled out.

”Very little is available about retail drug prices, health plans, and nothing on physicians,” he said. He noted that hospitals have been giving patients an estimate for years.

Requiring price disclosures from other providers were taken out of the bill early on, Ashwell said. “We’re starting with hospitals, but over time we want to create transparency in all medical expenses.”