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News & Press: State Legislation

Update - Alaska's Health Care Price Transparency Law

Monday, July 22, 2019   (0 Comments)
Posted by: Sheri Ryan
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UPDATE 07/22/2019

DRAFT Language NOW AVAILABLE for Public Review/Comment through 09/27/2019 on 7 AAC 86.Health Care Services Price Transparency.  

It's important to note that the requirement for ALL health care providers to report/post their price lists is already in statute.  If you choose to give public comment on the DRAFT regulations for  AS 18.23.400, please be respectful and frame your comments as constructive.  "Opting out" is not a valid comment.  

A new chapter, 7 AAC 86. Health Care Services Price Transparency, is proposed to clarify AS 18.23.400. Disclosure and reporting of health care services, price, and fee information (see below for statute language), including:

  • The method a health care provider and health care facility must comply with to
    • Report the price of health care services;
    • Post the price of health care services;
    • Provide a good faith estimate; and
  • The method the department will use to enforce the law.


See the State of Alaska online notice at https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=194917

Download the documents 


 ACS Overview of DRAFT Language

 

 Pros Cons
 Reporting

Offices will report their price list to the Department by sending an e-mail to DHSSpricereporting@alaska.gov with the URL (link) of the webpage where their price list is posted on their clinic website OR attach a PDF IF they do not maintain a website or social media presence.  

Please note - the department has made specific requirements for the title of email and the PDF that will be sent.  

Regulations states "Annually compile a list and report to the department the "applicable" number of health care services most commonly performed".  Define "applicable".  Statute states "10 health care services most commonly performed by the health care provider in the previous calendar year from each of the six sections of Category 1, Current Procedural Terminology, adopted by the American Medical Association."  The six sections for Category 1 are evaluation and management; anesthesiology; surgery; radiology; pathology and laboratory; and medicine. For most offices that would mean ten from E/M, ten from radiology, and 10 from medicine - 30 commonly performed services.  Does the regulation downgrade the requirement of the number of services we must list/report?  Point - many chiropractic offices do not utilize up to 10 services under each category on a regular (commonly performed) basis.   

If the office does NOT have a website - they do not have to create a website to report their price list to the department.  They can submit their price list via PDF to the department.   If an office maintains a social media presence (FaceBook, Instagram, Twitter, etc.) but does not have a website, they must post their price list via their social media account to comply. Define "uses social media".  If the clinic hasn't posted since 2014 does that mean they "use social media"?  My question to an office that hasn't posted since 2014 - why do you have a Facebook account?  Delete it.  
 You can use social media to meet posting requirement if you do not have a website.  
 Posting
Price list does NOT have to be posted on paper in your waiting room.  It can be posted via computer screen or electronic screen in waiting area. The screen must display with a minimum 20 font size. This will definitely save on required "wall art". Many offices have patient education monitors in your waiting room.  You could post your price list in rotation.  You could have an electronic photo frame on your front desk with the posted information.  It could be part of your electronic check in process.  You could have a monitor on your front desk displaying your website page with your price list.   Must be posted in a conspicuous space where patients check in and wait to see a health care provider.  This would be in addition to any Muni requirements you may already have in offices located in Anchorage.  
   Satellite offices have to post in their waiting areas also.  You cannot just post in main office only.  
     Offices are required to post their undiscounted price list in BOTH their office waiting room AND on their website for their clinic, if they have a website.  In statute, it is suggested that you include a statement explaining that the undiscounted price may be higher or lower than the amount an individual actually pays for the health care services described in the list.  See the statute listed below.  
   Offices are required to post their price list by 1/31 every year and update annually.  One would assume that if your prices change - you would need to update - what is the time requirement for that posting?  
 Good Faith Estimates
 Good Faith Estimates must be requested by patients in writing.  Patients must provide full name, mailing address, email address, phone number, preferred method to receive estimate, condition the medical treatment estimate is to address.    Offices will need to create a form for patients to complete to gather needed information to comply.
 Enforcement  
 

This section seems inadequate.  My concerns is with the verbiage relating to when the Department receives a report that you failed to report or post and they "MAY" seek confirmation.  A better choice of words in this case would be "WILL" seek confirmation.  The use of 'may" might lead you to think that the department would take the report as truthful and not seek confirmation.  

My next concern is the next section.  IF the department determines you failed to report/post, they MAY call you, send you a letter, issue a warning, or assess a fine.  Each of these actions appear to have the same ranking.  There should be delineated progression in the adverse action that will be taken here.  Something like - at your first substantiated report, you will get a phone call.  If you don't correct in 30 days, you will get a letter.  If you fail to respond/act, you will get a warning.  If you fail to comply in 90 days, you will be assessed a fine.  

   Fine for violation is $100/day of noncompliance.  YIKES!  Be forewarned.  For one month of noncompliance - that would be a $3,000 fine.  
   

You may comment on the proposed regulation changes, including the potential costs to private persons of complying with the proposed changes, by submitting written comments to the Department of Health & Social Services, Division of Public Health, Health Analytics & Vital Records, P.O. Box 110675, Juneau, Alaska 99801. Additionally, the Department of Health & Social Services will accept comments by facsimile at (907) 465-3423 and by electronic mail at clint.farr@alaska.gov . The comments must be received not later than 5 p.m. on September 27, 2019.

Oral or written comments also may be submitted at a hearing to be held on August 28, 2019, at the Frontier Building, conference rooms 880 and 890, 3601 C St. Suite 902, Anchorage, AK 99503. The hearing will be held from 1:00 p.m. to 3:00 p.m. and might be extended to accommodate those present before 2:45 p.m. who did not have an opportunity to comment. If you are unable to attend in person, but would like to comment during the oral public hearing, you can call the teleconference Toll Free Access number (800) 616-4707.


Here's the statute that the regulations above were written for http://www.legis.state.ak.us/PDF/30/Bills/SB0105Z.PDF

Article 4. Health Care Services and Price Information.  AS 18.23.400 

Sec. 18.23.400. Disclosure and reporting of health care services, price, and fee information. (a) A health care provider shall annually compile a list, including a brief description in plain language that an individual with no medical training can understand, of the 10 health care services most commonly performed by the health care provider in the state in the previous calendar year from each of the six sections of Category I, Current Procedural Terminology, adopted by the American Medical Association and, for each of those services, state

                              (1) the procedure code;

                              (2) the undiscounted price; and

                              (3) any facility fees.

                      (b) A health care facility in the state shall annually compile a list, including a brief description in plain language that an individual with no medical training can understand, of the 10 health care services most commonly performed at the health care facility in the previous calendar year from each of the six sections of Category I, Current Procedural Terminology, adopted by the American Medical Association and, for each of those services, state

                             (1) the procedure code;

                             (2) the undiscounted price; and

                             (3) any facility fees.

                     (c) If, in the annual reporting period under this section, fewer than the number of health care services described under (a) or (b) of this section are performed by a health care provider or at a health care facility in the state, the provider or facility shall include in the list required under this section all of the health care services performed by the provider or at the facility from each of the six sections described under (a) or (b) of this section.

                    (d) A health care provider who provides health care services at a health care facility in a group practice is not required to compile and publish a list under (a) and (e) of this section if

                           (1) the health care facility where the provider is in a group practice compiles and publishes a list in compliance with (b) and (e) of this section; and

                           (2) the prices and fees that the provider charges are reflected in the list compiled and published by the health care facility  

     (e) A health care provider and health care facility shall publish the lists compiled under (a) and (b) of this section by January 31 each year

                           (1) by providing the list to the department for entry in the department's database under AS 18.15.360 along with the name and location of the health care provider or health care facility; 

                           (2) by posting a copy of the list 

                                       (A) in a font not smaller than 20 points; 

                                       (B) in a conspicuous public reception area at the health care  provider's office or health care facility where the services are performed; 

                                       (C) that includes the address for the department's Internet website; 

                                       (D) that may include a statement explaining that the undiscounted price may be higher or lower than the amount an individual actually pays for the health care services described in the list;

                                       (E) that includes a statement substantially similar to the following: "You will be provided with an estimate of the anticipated charges for your nonemergency care upon request. Please do not hesitate to ask for information."; and

                                        (F) that lists any health care insurers with which the health care provider or health care facility has a contract to provide health care services as an in-network preferred provider; and

                         (3) if the health care provider or health care facility has an Internet website, by posting the list on the website. 


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