Senate passes de la Cruz bill on Hospital Pricing Transparency

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STATE HOUSE — The state Senate passed legislation introduced by Minority Leader Sen. Jessica de la Cruz, a Republican representing District 23 in North Smithfield, Burrillville and Glocester, that would provide a procedure requiring health care facilities to maintain a searchable price list for all facility items. 

This legislation is part of the larger Senate HEALTH package rolled out in March of this year. It requires hospitals to publish and maintain a single machine-readable file that contains a list of all standard charges for all facility items or services. According to the legislation, hospitals would also have to publish and maintain a consumer-friendly list of searchable standard charges for at least 300 services, including 70 services identified by the Centers for Medicare and Medicaid Services. The bill would require each facility of a hospital system to maintain and publish its own list, and the list would need to include a description of the items or services, the gross charge, minimum and maximum negotiated charges, discounted cash price, payor specific negotiated charge and billing code.  

For compliance, the Department of Health would monitor and enforce compliance by evaluating complaints, reviewing any analysis conducted on compliance, auditing the websites of hospitals and confirming compliance with them.

“In 2019, a federal regulation known as the federal hospital transparency rule was enacted to do this, but since then, approximately only 16 percent of hospitals are estimated to be compliant with federal transparency requirements, largely due to lack of broad enforcement by the Centers for Medicare and Medicaid Services,” said de la Cruz. “The federal requirements were a great start but the additional penalties in this policy will encourage better compliance rates.”

“Important benefits for consumers include up-front access to price information for patients so they can make informed healthcare decisions, shop for care based on procedure prices at different hospitals near them, and avoid unexpectedly high bills in the mail,” said de la Cruz. “Additionally, it encourages greater hospital compliance with transparency requirements and transparent prices mean expanded competition and lower prices.”

The measure now moves to the House, where Rep. Julie Casimiro a Democrat representing District 31 in North Kingstown and Exeter, has introduced companion legislation.

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