Bill would increase health cost transparency
Contributed Article
AUGUSTA — State Sen. Rodney Whittemore (R-Skowhegan) has submitted legislation that seeks to improve transparency in health care and lower consumer costs.
LD 1305, “An Act to Improve Price Transparency, Help Maine Consumers Comparison Shop for Certain Health Care Procedures and Lower Health Care Costs,” contains several provisions that aid consumers in making better choices about their own health care, according to Whittemore.
Maine Senate Republican Office
Sen. Rodney Whittemore
A public hearing was held on Tuesday, May 5 and a work session is scheduled for later this month.
The bill would require that health insurance carriers establish a toll-free telephone number and publicly accessible website to provide information to enrollees about health care costs.
Additionally, the bill requires a health insurance carrier to pay an enrollee 50 percent of the saved cost to a maximum of $7,500 if an enrollee elects to receive health care services from a provider that costs less than the average cost for a particular admission, procedure, or service unless the savings is $50 or less.
Presenting the bill in front of the Legislature’s Joint Standing Committee on Insurance and Financial Services, Whittemore offered an example of how such a payment to an enrollee would work.
“I had an annual physical recently and received a bill showing the basic lab work was over $700. Had this law been in place, I could have made a few calls or looked online to see what the average cost of that blood work was at different locations near my home,” said Whittemore.
“If the average was $500 in my county and I chose a location that cost $200, the total cost of the labs would have been $350; $200 paid to the provider and $150 paid to me for taking the initiative to shop,” he added. “At a total cost of $350, I would have saved, my insurer would have saved, and we would have rewarded a provider in the community for providing a fair price for the service. The ability to price shop is available currently; however there is no incentive to do so. LD 1350 will provide that incentive and drive down the overall cost of health care.”
Whittemore said that if lawmakers “do our very best to find the near-perfect ethical balance between consumers, carriers, and providers, we would be sailing in a direction that lowers the cost of health care, maintains a high level of quality health care, and binds together all the components necessary for a fair and balanced health care system.”
Whittemore’s Senate district encompasses more than 30 towns, plantations and unorganized townships including Seboomook, North East Carry and Rockwood in the Moosehead Lake region.