Health Care Price Transparency

Health Care Price Transparency

Wednesday, February 5, 2020

Increasing health care price transparency for Hoosiers is a top priority this session. The Senate Republican caucus has authored a number of bills that would make health care pricing more transparent and hopefully drive down costs. The following bills have passed out of the Senate:

Senate Bill 3 would limit surprise billing by requiring hospitals to give patients a good faith estimate for the cost of services upon request. Right now, patients can be subject to a "surprise" medical bill when they receive care from multiple providers at one location, but only some of those providers are in the patient’s insurance network. This would let patients know ahead of time if any services will be done by an out-of-network provider.

Senate Bill 4 aims to increase health care cost transparency for Hoosiers by creating an All-Payer Claims Database (APCD). Over 30 states have or are implementing an APCD, which is a large-scale database that systematically collects health-insurance claims for both services and medications. An APCD would give Hoosiers the ability to shop for the best-priced health care. APCDs do not collect any identifying information about individuals.

Senate Bill 5 would end gag clauses in health provider contracts. This would allow employers to find out how much they are being charged for services under their employee health insurance plan and better negotiate the most cost-effective coverage for their employees.

Senate Bill 184 would allow the Indiana Farm Bureau to benefit its members by offering health care coverage. Farmers face unique challenges in buying health insurance because they are independent business owners with volatile income. SB 184 would create a new option to make life easier for Hoosier farmers.

Senate Bill 241 would require pharmacy benefit managers, which are agents who serve as middlemen to help insurance companies negotiate contracts, to be licensed under the Department of Insurance (DOI) and provide their proprietary information on rebates, prices and discounts to the DOI. This will let the state see if rebates and prices are appropriately accounted for.

To view these bills and others, visit www.iga.in.gov