Florida bill would make doctors, health centers post prices

The following article was published in the South Florida Sun Sentinel on January 24, 2012: 

Florida bill would make doctors, health centers post prices

By Bob LaMendola

Restaurants have menus, retailers have pricetags and soon, Florida doctors could have price boards.

Legislation in Tallahassee would force doctors and some medical care centers to post signs of about 3-feet-by-5-feet in their waiting rooms showing the prices to be charged a person paying out of pocket. Charges for the insured vary by policy and wouldn’t be posted.

“The cost of health care is a big mystery. Nobody knows how much health care costs. We need some clarity,” said Rep. Richard Corcoran, R-Trinity, the sponsor of one of the bills. “When consumers are price-conscious, they shop around, and there’s competition. That lowers costs and gives better quality.”

In addition, lawmakers would give a price break to patients who can’t give permission for treatment by a health provider that’s not part of their insurance network, such as when an ambulance rushes them to the nearest hospital.

The bills by Corcoran (HB 1329) and the Senate Health Regulation Committee chaired by Sen. Rene Garcia, R-Hialeah (SB 7186) are moving in the Legislature. Both come up for hearings on Wednesday.

The bills have drawn opposition from the powerful lobbyists of doctors, hospitals and other health businesses who argue the rules are punitive and take money from them.

Here’s what the bills would do:

Medical prices: Urgent care centers, surgery centers and imaging centers would have to post the signs showing prices for their 50 most common procedures.

Doctors’ offices would have to post prices on those signs under one bill; both bills require doctors to give each patient a price sheet at every visit. A Corcoran bill that become law last year made price disclosures voluntary for doctors, but few have done so, he said.

Medical groups said they not object to disclosing prices but don’t want to be forced to put up signs that would cost money and clutter waiting rooms.

“It doesn’t really help patients,” said Alison B. Dudley, a lobbyist for the imaging specialists in the Florida Radiological Society. “If I were shopping, I would prefer to do it by phone from my home rather than drive around to a bunch of places and look at the walls.”

Corcoran said he is a fan of price signs, having once been a consultant for Solantic, a chain of 30 Florida urgent care centers that features prominent price signs.

Hospital-owned urgent care: Each would have to post a sign telling patients if prices are the same as those charged in their hospital emergency room. Legislators said they have heard many complaints from patients who expected to be billed a lower fee typical of urgent care centers, but instead were billed at higher ER prices.

That’s what happened to Pembroke Pines insurance worker Lori Wills, who did not complain to the legislators. She had a five-minute doctor visit for a sore throat at a hospital-owned urgent clinic last year. The clinic could not tell her the price, but when the bill arrived later, the clinic charged $925, the doctor $233.

“If they had told me, I would have walked out,” said Wills, who is still fighting the charge. Shortly after the visit, she was treated for the same throat ailment at another urgent care center for $100.

Officials at some hospital-owned urgent clinics say they charge ER prices because the clinics do more than typical urgent care centers and serve as extensions of their emergency rooms. They say they are making clinic prices clearer to patients.

No out-of-network fees if you can’t choose: Patients almost always pay extra if they are treated by doctors and medical centers that are not included in their insurer’s network.

But what happens if you’re unconscious when an an ambulance takes you to an emergency room?

Both bills would waive extra fees for patients who had no control over whether they were treated by someone out of network. The patient would pay only the co-payment and deductible the insurer charges for in-network care.

The physician group Florida Medical Association opposes this, saying it would take money out of providers’s pockets. The legislation does not force insurers to pay non-network doctors or hospitals the extra fees that the patient would be excused from paying, the association said. Doctors may respond by no longer seeing out-of-network patients.

“The insurance company is the only winner in this scenario,” said FMA spokeswoman Erin VanSickle.

Gov. Rick Scott, who once owned Solantic, has taken no position on the two bills so far. Any bill approved by the Legislature would go to him for his signature.

But, Scott “believes that if consumers knew how much health services cost, they could make better informed decisions about their care — and it would create a more competitive environment among providers — which should ultimately reduce costs,” his office said in a brief statement.

Find this article here:  http://www.sun-sentinel.com/business/fl-medical-consumer-bill-20120124,0,7806900.story