Jan. 31, 2020
Increasing Health Care Transparency
Recent studies have demonstrated Hoosiers pay considerably more for some health care costs than citizens in other states.
To address this issue, the General Assembly is considering legislation this session that would help increase health care cost transparency. If patients have better access to information about the cost of care, the health care market can function more effectively and help drive down costs for everyone.
Addressing surprise medical billing
Patients can be subject to a “surprise” medical bill when they receive care from multiple providers at one location, but only some of those providers are in the patient’s insurance network. My Senate colleagues and I are working on legislation that would limit surprise billing by requiring hospitals to give patients a good faith estimate for the cost of services upon request. This request would let patients know ahead of time if any services will be done by an out-of-network provider.
Creating an All-Payer Claims Database
Another measure to increase health care cost transparency for Hoosiers would create an All-Payer Claims Database (APCD). Over 30 states have or are implementing an APCD, which is a large-scale database that systematically collects health-insurance claims for both services and medications. An APCD website would give Hoosiers the ability to shop for the best-priced health care. APCDs do not collect any identifying information about individuals.
Banning health insurance “gag clauses”
Currently, contracts between health care providers and insurance companies can include “gag clauses” that prohibit providers from disclosing cost information to the employers who sponsor insurance plans. To increase transparency and competition in the health care market, Senate Bill 5 would end gag clauses in health provider contracts. This would allow employers to find out how much they are being charged for services under their employee health insurance plan and better negotiate the most cost-effective coverage for their employees. Employers would not have access to individuals’ medical information or procedures/services received by the employee.
Health care costs are a big concern for all of us. As your state senator, I will support efforts to bring more price transparency in order to make the market work better for consumers.
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