Healthcare consumers may be getting some relief from high prices charged by physicians and hospitals.
The state Senate passed a measure last week that prohibits healthcare providers from reporting a healthcare debt to a credit bureau or pursue collection activities unless a good faith estimate of the cost of the procedure or care was presented before the service was provided.
“We are trying to protect the healthcare consumer at the front end,” said state Sen. Julie Daniels (R-Bartlesville). “We are trying to put in a market-based system.”
Daniels is the author of Senate Bill 548. The measure now heads to the state House for its consideration.
Daniels noted that the good faith estimates are not required if the healthcare providers do not turn the patient’s debt over to collection agencies.
However, there is some opposition to the measure from Oklahoma healthcare groups who claim they haven’t been consulted.
“While we are certainly willing to have a conversation with Sen. Daniels regarding SB 548, to date we have not been afforded this opportunity,” said Patti Davis, president of the Oklahoma Hospital Association. “As written, the bill is an unfunded mandate upon hospitals that would require all hospitals, large and small, rural and urban, to have a 24/7 billing department to provide a good-faith estimate of the total cost of services to be provided to a consumer prior to receiving services.”
The Ledger attempted to reach a representative from the Oklahoma State Medical Association but received no response.
However, Daniels said she has worked with the healthcare organizations to overcome their objections, but refused to “water it down where it becomes nothing.” The senator struck the title on the bill, which means the measure’s language has not been finalized, but can still move forward in the legislative process.
Part of Daniels’ motivation for the Senate bill is to stop the large number of lawsuits filed by hospitals against former patients and damaging their credit.
“I heard from people who have been sued by hospitals and harassed by collections companies,” the senator said. “Medical debt is the biggest reason for personal bankruptcy. This is our attempt to bring the consumer back to the conversation and to drive the healthcare industry into being more upfront.”
Hospitals filed about 22,000 lawsuits against former patients from January 16, 2015, to July 2019, Daniels said. About 5,000 of those lawsuits were filed by St. Francis Hospital in Tulsa.
“The aftermath of healthcare can be financially devastating to people, because they had no idea they were going to be hit with these bills before the care was provided,” Daniels said. “Over 50% of bankruptcies are due to medical debt. Patients need to know upfront what the cost is going to be so they aren’t hit with surprise bills that can wipe out their finances and ruin their credit. SB 548 is a consumer protection bill that encourages price transparency.”
The bill also addresses emergency services in cases where the patient is unable to make informed choices regarding their care. In those cases, an insured patient could only be charged the rates for an in-network facility or provider, which can be significantly less the amount charged for those out-of-network providers. For those who are uninsured, the amount charged can be no more than 165% of Medicare.
During a committee hearing on SB 548, Daniels said the rise in hospital prices has outpaced economy-wide inflation for decades, according to a report from the Oklahoma Council on Public Affairs.
In that same meeting, state Sen. Joe Newhouse compared the use of a good-faith estimate to a home mortgage.
According to the OCPA report, Newhouse said, “Why can’t we do the same thing for healthcare?”