On May 25, 2016, Missouri Senate Bill 608 was passed by the Missouri House and Senate. The Bill adds new requirements to the provision known as the “Health Care Cost and Transparency Act.” Beginning July 1, 2017, the new law would require all licensed health care providers, facilities, and imaging centers to provide an estimate on the cost of a particular health care service or procedure within three business days of a written request from the patient, along with a medical treatment plan from the patient’s health care provider. The estimate must only include those services within the direct control of the health care provider and the amount that will be charged to a patient if all of the charges are paid in full by the patient, without a public or private third-party paying for any portion of the charge. Further, these provisions do not apply to charges for hospital emergency departments.
If health care providers provide publicly available links to the estimated costs or post such costs on a publicly available website, they are not required to provide cost estimates to patients upon written request.
Beginning also July 1, 2017, hospitals will be required to make publicly available the amount that would be charged, without discounts, for each of the 100 most prevalent diagnosis-related groups, as defined by Medicare.
The Governor of Missouri has until July 14, 2016, to sign, veto, take no action, or veto line items of the Bill. If the Governor takes no action, the Bill will become law.
If the Bill becomes law as it is expected to, it will be interesting to see its implementation. In 2014, Massachusetts passed a similar price transparency law requiring hospitals, physicians, clinics, and insurance companies to give patients the price of medical services prospectively. The results of a study by Pioneer Institute were discouraging. The study found that many health care providers lacked systems or procedures for price inquiries. In the cases where price estimates were actually obtained, it took an average of two-to-four business days and numerous calls. Furthermore, the study found wide variation in price estimates.
Click here to read Missouri Senate Bill 608
Click here to read the Pioneer Institute’s Survey
For update posted on 7/15/16, go to Update: Governor Vetoes Missouri Senate Bill Imposing New Requirements on Health Care Providers
Posted by Attorney Katherine M. Flett. Flett is a member of the litigation team focusing on assisting clients with matters relating to business, civil and commercial litigation.