Politics

Georgia Bill Aims For Transparency In Health Care Pricing

February 25th, 2020

The bill would require health insurers to disclose what doctors in their network have accepted as payment for a medical procedure within the previous year.

Don Petersen / Associated Press

A bill advancing at the state Capitol in Georgia would allow patients to compare prices for a medical procedure, get an estimate of their out-of-pocket costs and assess the quality of doctors.

The state Senate voted 51-1 Tuesday in favor of the “Georgia Right to Shop Act, ” sending it to the House for more debate.

The bill would require health insurers to disclose what doctors in their network have accepted as payment for a medical procedure within the previous year. Insurers would also have to have a way on their website for consumers to compare “quality metrics” for in-network providers and get an estimate of out-of-pocket costs for a health service.

State Sen. Ben Watson, a Republican from Savannah who co-sponsored the bill, said it “provides sunshine or transparency.”

Prices for the same medical procedure can vary dramatically among doctors, but patients don’t currently have a way to see that so they can’t be good consumers, supporters of the measure say. The prices, they say, also have no connection to quality of care.

Allan Hayes, a representative for the group, America’s Health Insurance Plans, told state lawmakers at an earlier hearing that insurers want to see transparency across the health care industry, including from doctors and hospitals.

President Donald Trump’s administration last year unveiled similar rules, though it also called on hospitals to disclose their insurance rates and what they’d be willing to accept if a patient pays cash.

Hospitals and insurers said those rules would force them to publicly disclose rates they negotiate as part of private contracts that normally are beyond the purview of authorities.

Insurers also contended that the Trump plan could backfire, prompting providers that are accepting a bargain price to try to bid up what they charge if others are getting more.