How the Senate proposal to reduce healthcare costs would address transparency

Senate health committee leaders introduced a bipartisan legislative package to lower healthcare costs on June 19.

The legislation — formally introduced by Senate Health Committee Chairman Lamar Alexander, R-Tenn., and ranking member Patty Murray, D-Wash. — aims to stop surprise billing, improve healthcare transparency and increase prescription drug competition.

Four takeaways from the Lower Health Care Costs Act:

1. Gag clauses. Gag clauses that prevent health plan members or referring providers from viewing cost and quality data on providers would be prohibited in provider-insurer contracts.

2. Provider directories. Insurance companies would be required to keep updated directories of their in-network providers. They would have to provide this for patients online, or within 24 hours of a request.

3. Anticompetitive terms. The legislation bans "anti-tiering” and "anti-steering" clauses from insurer-provider contracts that keep an insurance company from directing patients to use less expensive providers and facilities or rewarding them for it.

4. Study. The U.S. Government Accountability Office would be required to study profit-sharing relationships between hospitals, contract management groups and physician and ancillary services, as well as government oversight of them.

Access the text of the legislation here.

 

More articles on healthcare finance: 

Senate committee tackles surprise medical bills: 5 takeaways
CMS, inpatient rehab facilities reach settlement on pending Medicare appeals
Texas hospitals maintain state funding for trauma care

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