DENVER (CBS4)– Imagine being able to go online and shop for health care like you would for anything else. Under a federal rule that took effect last year, hospitals would have to post online the prices they negotiate with insurers, but many have been dragging their feet.
Some state lawmakers say if fines don’t get their attention, maybe litigation will.
Representatives Patrick Neville, a Republican, and Daneya Esgar, a Democrat, are the sponsors of a bill that targets hospitals that have refused to post awards to protect profits above the federal penalties they face.
Their bill would allow people to sue and have their bill thrown out if, on the day they received care, the hospital did not comply with the federal rule. The hospital will also have to pay a fine and the patient’s attorney fees.
Neville says, “After three or four trials, they’ll all be compliant and we’ll probably never use this bill again.
Look no further than Avon’s Mason Kochel to understand how a little price transparency can make a huge difference, in his case, a difference of $15,000. David Kochel says his son went to the emergency room with a severe allergic reaction and left with an Epi-pen which, he says, the hospital listed for $600, but charged him $15,000.
“It was outrageous, blatant, possibly fraudulent. They called it a glitch in the billing system, but thousands of Coloradans experience issues like this every year.
Removing the secrecy surrounding hospital pricing is one of the few issues where Republicans and Democrats are on the same page. The federal rule was drafted by the Trump administration and implemented by the Biden administration.
Neville says price transparency is the best way to drive competition between hospitals and lower prices for all of us.
“It also gives employers the ability to go back and look and shop around and say ‘man, my employees are going to pay a lot less if I choose this policy or this hospital’, so it’s like real bargaining power. for employers, even labor groups, the state government could probably save a ton of money with this,” Neville said.
Kochel supports the bill which he hopes will make hospitals think twice before charging 15,000 for an Epi-pen, “In our case, the story has a happy ending. That’s not the case for most Coloradans, many of whom wouldn’t know how to dispute the bill and many of whom would have just paid it, so I think it’s really important that hospitals be held accountable.
The Colorado Hospital Association says it supports transparency, but the bill, it says, needs work, including a clear definition of what it means for a hospital to be in noncompliance. He argues that federal regulators, not the courts, are in the best position to decide.
The Hospital Association says that, based on a survey it conducted, 90% of hospitals here are in compliance with the federal rule. However, decrypting the data can be difficult, if not impossible, for consumers.
A federal rule taking effect this summer will allow tech companies to aggregate data and develop apps that allow people to easily compare the prices of individual procedures.
Neville suggests this will be a game-changer: “There are a lot of companies developing apps, so just like you can go to Gasbuddy.com and find the best gas station, you’re going to have different companies developing those apps. so if you want to go buy a service you can hop over there and see “oh if i drive another 10 miles i can save $3000 on my MRI” and guess what will happen? $000, and then the company that charges $3,000 more is going to consider losing all that business and say I need to lower my prices.
Neville says a study found that 30% of hospital costs are negotiated with insurance companies and 20% of insurance company costs are negotiated with hospitals.
The bill passed the House Health and Insurance Committee unanimously and is now heading upstairs.