Charles Ashby, The Daily Sentinel

DENVER — A bill that would require full transparency in medical pricing for providers and insurers is to get its first committee hearing this week.

The measure, HB1358, is nearly identical to a proposed ballot measure whose proponents say would end the secrecy in what medical procedures cost, creating a true free-market system in the health care industry.

Sen. Kevin Lundberg, R-Berthoud, is sponsoring the bipartisan bill with GOP Rep. Susan Beckman of Littleton and two Democrats, Rep. Mike Foote of Lafayette, and Sen. Irene Aguilar of Denver.

 

Like them, Lundberg said that by requiring providers to disclose their prices, and insurers to reveal their negotiated payments, patients would be able to see for the first time what they are being charged beforehand.

“Because it’s so ubiquitous to our culture, people are interfacing with the medical world on a daily basis and it’s gotten way out of control and way out of hand,” Lundberg said. “The dilemma is, we no longer have a free-market system when it comes to medical billing. It is so regulated and convoluted.”

Opponents to the measure, such as Cigna Insurance and medical and pharmaceutical associations, say the idea is too onerous, particularly for smaller health care providers.

They say the proposal requires them to list their “chargemasters,” an industry term for the full list of non-discounted charges for medical supplies and health care services. But doing so is easier said than done because those prices can change daily.

Proponents say that’s no different than the changing prices at a grocery store, which also can change on a daily basis.

“If you go into a grocery store, you expect to know what the price is before you put it into your cart,” Lundberg said. “You ought to be able to do that with medical procedures.”

Lundberg said the Legislature routinely calls for more transparency in medical costs, but usually in specific ways.

 

Senate Bill 146, for example, that is working its way through the Legislature now, does that for freestanding emergency rooms, which are often confused with cheaper urgent-care centers, he said.

He said secretive billing practices, combined with over-regulation, has made it nearly impossible for consumers to shop around.

“If you walk into a freestanding emergency clinic and ask a question like, ‘Does my insurance cover this,’ they will tell you federal law prevents me from telling you that until we treat you and send you the bill,” Lundberg said. “That’s just upside-down. Is this going to cost me nothing, hundreds or thousands?”

Meanwhile, other measures are being introduced to study other ways of reforming the health care system.

House Bill 1384 calls on the state to study the costs, benefits and feasibility of implementing a Medicaid buy-in option, a public-private partnership option, or a community- or regionally based option for health care coverage.

“We know too many Coloradans are harmed by high premiums and cost sharing, lack of competition and health insurance instability,” said Adela Flores-Brennan, executive director of the Colorado Consumer Health Initiative. “Rural Colorado was hit by average rate increases of 30 percent or more this year, and 14 counties have only one health insurer to chose from. We need to create new options for Coloradans.”

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