DAYTON, Ohio (WDTN) – A new Ohio law would require hospitals and doctor’s offices to be more transparent about what it costs to treat you. It’s supposed to go into effect in January, but it’s being blocked by the Ohio health care industry.
This law would require hospitals and other health care providers to give you a good faith estimate on what you would end up paying so you are not blindsided by bills. But the healthcare industry is saying not so fast and have filed a lawsuit to stop it.
Read entire complaint here: complaint-health care providers-vs-state
You get one before you pay a dime for repairs to your car and before that plumber fixes your sink, but how about getting an estimate at your doctor’s office before you get that procedure?
Ohio lawmakers passed that law in 2015. Local representative Jim Butler from Oakwood sponsored it.
“We get one good faith estimate of what the costs are, what your insurance payment is and what the patient responsibility, what your out of pocket is going to be,” said Butler.
Butler says the law requires hospitals and doctor’s offices to provide this written estimate for all non-emergency services before they are performed. Essentially you would know how much that x-ray would cost you before you get it done.
“Everyone knows our healthcare costs are out of control right now. They are rising. Our premiums are rising, we have more and more deductibles,” said (R) State Rep. Jim Butler.
The law was set to go into effect this year, but several health care organizations have filed a lawsuit to stop it claiming it’s just not feasible.
“It’s just generally unworkable. It requires healthcare providers to provide information to patients they simply do not have prior to delivering the service,” said Sean McGlone.
McGlone is the Senior Vice President and General Council with the Ohio Hospital Association, one of the organizations suing the state. The others listed on the lawsuit include Community Hospitals and Wellness Centers, Ohio State Medical Association, Ohio Physiological Association, Ohio Physical Therapy Association, Ohio Chapter of the American Academy of Pediatrics, Ohio Chapter of the American College of Surgeons, and the Ohio Osteopathic Association.
He says there’s not one set cost for a procedure or doctors visit. So he says every person is different depending on their insurance and finding out the exact cost would take a long time.
“Right now, systems don’t exist widely to access that information -it often does take a phone call, hours and days of back and forth with the health plan to get that particular information for a particular patient,” said McGlone.
The lawsuit claims the law is vague in what is defined as a non-emergency and could disrupt and damage patient care.
“They don’t want us to know what they are charging. That’s the bottom line here,” said Butler.
Butler said all these concerns would have been addressed and clarified if the Kasich administration would have drafted the rules to the law like they were supposed to by last July.
“Right after that compromise was reached and it passed unanimously and the Governor signed it the Kasich administration has been trying to make the law go away by not drafting rules,” said Butler.
2 NEWS Investigates asked the Kasich Administration about it. The Director of Government Affairs and Communications sent a statement back that says Butler doesn’t have all the facts. It says, “our administration supports prices transparency and we have made a good faith effort to find a path forward. We certainly wish the differences between Rep. Butler and other interested parties would have been corrected through legislative rather than legal means, but when facing a legal challenge, we will always act in the best interest of Ohioans.”
According to McGlone, the Ohio healthcare industry has offered a compromise. They’re willing to do the estimate of costs for non-emergency services if a patient asks for it and they would provide an estimate for a select group of other services that many patients shop for such as MRI’s and x-rays. He says they are not against transparency, they just want it be be fair to patients and providers.
“What this law proposes is really the thing we should all be striving toward but we are not there yet,” said McGlone.
Butler says he’s willing to work with health care providers in making the law clearer and easier to implement but doesn’t want to limit the scope. He says patients deserve more.
“It makes sense that if a car repair shop can do it with all the resources and technology that healthcare has that they would be able to provide it,” said Butler.
A hearing set for January 20th that will determine what’s next with the lawsuit and if and when the law would go into effect.
Representative Butler has asked the Ohio Attorney General’s Office to assign a special counsel to represent the State of Ohio because he does not believe the Kasich administration supports the law.
Read Rep. Butler’s response to Ohio Hospital Association here: butler-ltr-to-oha