A.G. Gancarski
The phrase “you better shop around” applies to love, according to at least one old song. And a Florida House bill would apply that to medical procedures as well.
On Tuesday, Rep. Paul Renner filed House Bill 449 (the “Patient Savings Act”) in the Florida House.
The bill would create a “shared savings incentive program” starting on Jan. 1, 2018 as a component of the policy.
The shared savings incentive program would allow “insureds [to] receive cash payment as incentive to save on certain non-emergency health care services.”
To that end, the bill requires an insurer to provide “good faith estimates” of costs for a wide range of “shoppable” health care services when asked, which include things ranging from OB/GYN visits and outpatient surgery to occupational therapy.
The insurer would be required to provide a method to obtain costs for procedures, and to compare the average price among health care providers.
A “good faith estimate” of the price would have to be provided within two working days of the request, with the caveat that unforeseen circumstances could adjust that estimate.
Cash payments would be provided to the insured when he or she procures a service at less than the average cost of the service, with the payments being at least 50 percent of the money saved compared to that average cost. That applies to both in-network and out-of-network providers.
The Renner measure would also set up penalties for non-compliance by insurers, with a $2,500 daily penalty imposed on insurers who fail to file an annual report with the state Office of Insurance Regulation outlining their compliance with the program, including amount of disbursements, money saved, amounts of insurers who used the program, and types of procedures covered.
In turn, OIR would provide its own report on the program to legislative leadership by April 1, 2019, and
