N.C. bill requires providers to disclose costs via state HIE

Legislation introduced March 27 by North Carolina state senators Bob Rucho and Harry Brown seeks a number of measures to improve transparency in healthcare costs provided by hospitals and ambulatory surgical facilities.

The bill, Health Care Cost Reduction and Transparency Act of 2013, intends to disclose to the public the cost of the 50 most common episodes of care through the state’s health information exchange utilizing EHR software. This would include:

• The amount charged to a patient for each episode of care if all charges are paid in full, along with a separate listing of the facility fees charged by health care providers for each episode of care
• The total amount of Medicaid or Medicare reimbursement for each episode of care
• Disclosure from the five largest health insurers the range of the total amount of payments for each episode of care; and
• The total amount of payments made to teachers and state employees for each episode of care.

The bill also seeks to prevent duplicate charges for certain radiological services. It specifically prohibits “an ambulatory surgical facility or provider affiliated with the facility, to charge a patient more than once for the full amount of the technical components of radiology imaging procedures during a multiple radiology session if the surgical facility or affiliated provider only provides the technical components one time during the multiple radiology.

If passed, the legislation would go into effect Jan. 1, 2014.